Cerebral PalsyCerebral Palsy

H.Makhmalbaf MDH.Makhmalbaf MD

Consultant Knee SurgeonConsultant Knee Surgeon

Cerebral palsyCerebral palsy

• Description

• Prenatally ,30%

• Perinatally ,60%

• Postnatally ,10%

EpidemiologyEpidemiology

• 0.6-5.9 patients in 1000 live births

• Prenatal care

• Socioeconomic condition of parents

• Type of obstetric &pediatric care the mother & child receive

• In the USA 2/1000 live births

• NICU ,low birth weight

Types of CPTypes of CP

• Spastic 65% injury to pyramidal tracts

• Athetosis is a type of dyskinesia ,injury to extrapyramidal brain lesion– Dystonic Athetosis ,choreiform– rigid athetosis

• Ataxic

• Mixed ,both pyramidal & extra

Types of CPTypes of CP

• If the lesion is in the cortex

• Midbrain or base of the brain

• Cerebellum ,ataxia

• Widespread brain involvement

studiesstudies

• Cerebral blood flow

• CT

• US

• MRI

• In the NICU’s

Prenatal causesPrenatal causes

• Congenital brain defect

• Mother had rubella or viral infection

• Erythroblastosis fetalis

• Fetal anoxia

• Maternal cardiovascular disease

• Alcohol ,diabetes mellitus ,thyroid abnorm

Natal causesNatal causes

• Trauma or asphyxia

• Trauma ,internal cerebral hemorrhage

• In eclampsia

• Delay in delivery

• Fetal aspiration

• Anaesthetic complications

• Prematurity

Postnatal causesPostnatal causes

• Encephalitis

• Meningitis

• Trauma ,head injuries

• Vascular accidents

• Asphyxia

• Prevention – immunization ,antibiotics

Clinical typesClinical types

• Or geographic classification

• Monoplegia

• Hemiplegic

• Diplegia

• Quadriplegia

DiagnosisDiagnosis

• Newborn or childhood

• Developmental delay

• Tests

• Reflexes

DeformitiesDeformities

• Spine

• Shoulder

• Elbow

• Wrist

• Hip ,knee ,ankle

TreatmentTreatment

• Physical independence

• Commiunication

• Mobility ,activity of daily life

• Ambulation

• Surgical treatment

THANK YOUTHANK YOU