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Cerebral palsey (CP) is defined as a nonprogressive disorder of posture and movement, often associated with epilepsy and abnormalities of speech, vision, and intellect resulting cerebral palsy, brain damage, cerebral palsey
EPIDEMIOLOGY AND ETIOLOGY. The reported the prevalence rate of cerebral palsey is 4/1,000 live births. Birth asphyxia was an uncommon cause of CP; moreover, most high-risk pregnancies resulted in neurologically normal children. Although a cause for CP could not be identified in most cases, a substantial number of children with CP had congenital anomalies external to the central nervous system (CNS), which may
CLINICAL MANIFESTATIONS. CP may be classified by a description of the motor handicap in terms of physiologic, topographic, and etiologic categories and functional capacity. The physiologic classification identifies the major motor abnormality, whereas the topographic taxonomy indicates
Infants with spastic hemiplegia have decreased spontaneous movements on the affected side and show hand preference at a very early age. The arm is
Spastic diplegia refers to bilateral spasticity of the legs. The first indication of spastic diplegia is often noted when the infant begins to crawl. The child uses the arms in a normal reciprocal fashion but tends to drag the legs behind more as a rudder (commando crawl) rather than using the normal four-stance crawling
Spastic quadriplegia is the most severe form of CP because of marked motor impairment of all extremities and the
Athetoid CP is relatively rare, especially since the advent of aggressive management of hyperbilirubinemia and the prevention of kernicterus. These infants are characteristically hypotonic and have poor head control and marked head lag. Feeding may be difficult, and tongue thrust
DIAGNOSIS. A thorough history and physical examination should eliminate a progressive disorder of the CNS, including degenerative diseases, spinal cord tumor, or muscular dystrophy. Depending on the severity and the nature of
TREATMENT. Parents should be taught how to handle their child in daily activities such as feeding, carrying, dressing, bathing, and playing in ways that will limit the effects of abnormal muscle tone. They also need to be instructed in the supervision of a series of exercises designed to prevent the development of Several drugs have been utilized to treat spasticity, including dantrolene sodium, the benzodiazepines, and Intrathecal baclofen has been used successfully in selected children with severe Patients with incapacitating athetosis will respond to levodopa, and children with dystonia may benefit from carbamazepine, trihexyphenidyl or