cerebral palsy
Summary
Cerebral palsy is a group of permanent movement and posture disorders caused by non-progressive brain injury occurring before, during, or shortly after birth. It is the most common cause of childhood physical disability, characterized by spasticity, ataxia, or dyskinetic movements depending on the brain region affected.
Detail
Cerebral palsy results from damage to the developing brain, typically affecting motor cortex, basal ganglia, or cerebellum. Risk factors include prematurity, low birth weight, birth asphyxia, infections (TORCH), and maternal factors. The condition is classified by motor type: spastic (most common, 70-80%), dyskinetic (athetoid/dystonic movements), ataxic (coordination problems), or mixed. Spastic CP is further subdivided by distribution - hemiplegia (one side), diplegia (legs > arms), or quadriplegia (all four limbs). Associated complications include intellectual disability (50%), seizures (25-35%), visual/hearing impairments, feeding difficulties, and orthopedic problems like contractures and scoliosis. Diagnosis is clinical, supported by neuroimaging showing periventricular leukomalacia, cortical atrophy, or basal ganglia lesions. Early intervention with physical therapy, occupational therapy, and spasticity management (baclofen, botulinum toxin, selective dorsal rhizotomy) can improve functional outcomes.
Sources
- Nelson Textbook of Pediatrics
- Adams and Victor's Principles of Neurology
- First Aid for the USMLE Step 1
- UpToDate Clinical Decision Support
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