Cerebral Palsy: An Overview

Abstract

Cerebral palsy (CP) is a neurodevelopmental disorder characterized by abnormalities of muscle tone, movement and motor skills, and is attributed to injury to the developing brain. The clinical features of this entity evolve over time and the specific CP syndrome may be recognizable only after 3-5 y of age; although suggestive signs and symptoms may be present at an earlier age. The management involves neurological rehabilitation (addressing muscle tonal abnormalities, and devising physical and occupational therapies) and diagnosis and management of co-morbidities (including epilepsy, impairment of cognition, vision, hearing, and disturbances of growth and gastrointestinal function). The management, therefore, is multidisciplinary involving the treating physician working with a team of rehabilitation-, orthopedic-, psychologic-, and social care- providers.

Activity limitation and match load in para‐footballers with cerebral palsy: An approach for evidence‐based classification

“…This study demonstrated that coordination tests such as SJ and SS can discriminate between different levels of impairment due to (a) a bilateral spasticity (ie, FT5) that causes velocity‐dependent muscle resistance affecting inter‐limb coordination and performance of shorter strides; (b) a profile of ataxia (impaired control of voluntary movement), athetosis (involuntary contractions of the muscles), or dystonia (sustained muscle contractions that cause twisting and repetitive movements or abnormal postures) (ie, FT6) that affects whole‐body coordination; or (c) a reduced between‐limbs synchronization due to an unilateral spasticity or hemiplegia . With regard to balance, it is well known that people with CP are characterized by the performance of mass instead of fine and individual movements, performing slow and effortful voluntary movements that affect their capacity to keep an upright weight‐bearing position . Our measurement of static balance by the OLS test demonstrates that upper motor neuron signs associated with CP such as extensor plantar response for those with lower limb spasticity (ie, FT5 and FT7), impaired voluntary control due to ataxia or that the involuntary contractions of the muscles in athetosis constrains balance performance.…”

A 4‐year follow‐up case of extrusive luxation in a patient with cerebral palsy

“…Manifestations depend on the extent and location of the brain injury in addition to the ability of the brain to adapt to it. The motor alterations include several disorders/defects: disorders of postural fixation; defects in the suppression of archaic reflexes; paresis; paralysis or disorders in the functional patterns of voluntary motor function; spasticity; and other muscle tone disorders . Traditionally, CP can be classified according to the part of the body that is affected (hemiplegia, diplegia, tetraplegia, monoplegia, or triplegia) or according to the predominant movement disorder.…”

“…Most of the CP patients are spastic (80%), 15% present dystonic or dyskinesia, and there is a lower proportion of patients with ataxia. However, very often, several types of movement disorders occur together in a child with CP . The exact etiology can be identified only in 40% to 50% of all cases.…”

“…The motor alterations include several disorders/defects: disorders of postural fixation; defects in the suppression of archaic reflexes; paresis; paralysis or disorders in the functional patterns of voluntary motor function; spasticity; and other muscle tone disorders. 5 Traditionally, CP can be classified according to the part of the body that is affected (hemiplegia, diplegia, tetraplegia, monoplegia, or triplegia) or according to the predominant movement disorder. Most of the CP patients are spastic (80%), 15% present dystonic or dyskinesia, and there is a lower proportion of patients with ataxia.…”

“…However, very often, several types of movement disorders occur together in a child with CP. 5 The exact etiology can be identified only in 40% to 50% of all cases. CP-associated conditions or risk factors can be divided into those that occur in the prenatal period (hypoxia, genetic, and metabolic disorders, multiple gestations), perinatal (including asphyxia, premature birth at < 32 weeks and/or weight < 2,500 g), or postnatal (asphyxia, seizures, cerebral infarction, sepsis, and respiratory distress syndrome).…”