cerebral palsy definition | cerebral palsy types

 CEREBRAL PALSY DEFINATION / TYPES OF CP ( LITTLE’S DISEASE )

Defination

It’s

1) Persistent but not unchanging disorder of movement, tone and posture

2) due to non-progressive defect / lesion of immature brain at fetal life, infancy and childhood.

Also associated with spectrum of developmental disability such as

Ø Mental retardation

Ø  Epilepsy

Ø  Visual, hearing and speech defects

Ø  Strabismus

Ø  Cognitive dysfunction

Ø  Sensory, emotional and behavioral problems

                                                         OR                                                                     

Umbrella term covering non-progressive but often changing motor impairment syndrome that may or not involve sensory deficits that are caused by a non-progressive defect , lesion or anomaly of the developing bran and that can be in part a developmental diagnosis

First described by William Little in 1862.Then it was known as Little disease.

Classification

	TOPOGRAPHIC		PHYSIOLOGICAL
1	MONOPLEGIA	1	SPASTIC
2	HEMIPLEGIA	2	EXTRAPYRAMIDAL
3	DIPLEGIA	3	ATAXIC
4	QUADRIPLEGIA	4	MIXED
5	DOUBLE HEMIPLEGIA	5	ATONIC
6	TRIPLEGIA	6	ATHETOID

TOPOGRAPHIC CLASSIFICATION

 

Topographic Classification of CP.

PHYSIOLOGICAL CLASSIFICATION

1) SPASTIC CP

Spasticity is defined as an velocity dependent increase in the physiological resistance of muscle to passive motion.

Result from damage to motor areas of the cerebrum; characterized by increased muscle tone, primarily of flexors and internal rotators, which might lead to permanent contractures and bone deformities.

SPASTIC DIPLEGIC

Involvement of legs more than arms often associated with premature birth. Only 11-20% are severely impaired.MR not so profound.

SPASTIC QUADRIPLEGIA

Involvement all four limbs, arms at least severely affected as leg. Severely impaired and MR. Often have bulbar symptomatology.

SPASTIC HEMIPLEGIA

Involvement of arm and leg on one side(arm > leg). Motor handicaps at least likely to be disabling. Intelligences is normal to dull.

2) ATAXIC CP

Ataxia is loss of balance, coordination, and fine motor control. Ataxic children cannot coordinate their movements. They are hypotonic during the first 2 years of life. Muscle tone becomes normal and ataxia becomes apparent toward the age of  2 to 3 years. Children who can walk have a wide-based gait and a mild intention tremor .Fine motor control is poor. Ataxia is associated when there is damage to the cerebellum (centre of balance and co-ordination).

3) ATHETOSIS CP

A condition that occurs when there is damage to the basal ganglia (masses of gray matter composed of neurons located deep within the cerebral hemispheres of the brain) results in an overflow of motor impulses to the muscles. Some characteristics of this type of CP include slow, writhing movements that are uncoordinated and involuntarily.

4) MIXED CP

Children with a mixed type of CP commonly have mild spasticity, dystonia. Ataxia may be a component of the motor dysfunction in patients in this group. Ataxia and spasticity often occur together. Spastic ataxic diplegia is a common mixed type that often is associated with hydrocephalus.

AREA AFFECTED IN CP

Site of brain injury	Pathological
Cortical	Periventricular lucomalacia   » Spastic diplegic
Sub-cortical	Stroke in utero  » Hemiplegic
Periventricular	Multifocal encephalomalacia  » Quadriplegia
Basal ganglia	Cerebellar  » ataxia
Cerebellum	Basal ganglia, thalamus, putamen  » dyskinetic
Brain stem