Cerebral Palsy 2
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| What indicators are highly predictive of CP? | LBW & prematurity (significant), hypertonus at birth, delayed motor milestones at 4 months, multiple births. | |
| What is the most common type of CP? | Spastic. | |
| What is the area of CNS damage in spastic CP? | Primary motor cortex or corticospinal pathways. | |
| What is the distribution of spastic CP? | Mono, hemi, di, or quadriplegia. | |
| What are the common patterns of hypertonia in spastic CP? | Hip and shoulder adductors, IR, extensors, elbow, wrist, finger, and ankle flexors, forearm pronators. | |
| What are the deformities seen in spastic CP? | Contractures, hip subluxation/dislocation due to poor posture/positioning, muscle imbalances. | |
| What are other signs associated with spastic CP? | Increased deep tendon reflexes, clonus, exaggerated positive support reaction. | |
| What is the area of CNS damage in athetoid CP? | Basal ganglia | |
| What is the distribution of athetoid CP? | Usually quad, hemiplegia is rare. | |
| What are the common patterns of muscle tone in athetoid CP? | Large sudden fluctuations between hyptonia, normal tone, and hypertonia, usually a spastic component. | |
| What are the deformities seen in athetoid CP? | None, unless there is a spastic component, at risk for dislocations if hypotonic due to hypermobility. | |
| What are other signs associated with athetoid CP? | Normal deep tendon reflexes. | |
| What is the area of CNS damage in ataxic CP? | Cerebellum. | |
| What is the distribution of ataxic CP? | Usually quadriplegia. | |
| What are the common patterns of muscle tone in ataxic CP? | Usually hypotonic, may have spastic or athetoid component, may have intention tremors. | |
| What are the deformities seen in ataxic CP? | None. | |
| What are other signs associated with ataxic CP? | Decreased deep tendon reflexes. | |
| What is the area of CNS damage in flaccid CP? | Motor cortex or brainstem. | |
| What is the distribution of flaccid CP? | Usually quadriplegia. | |
| What are the common patterns of muscle tone in flaccid CP? | Usually hypotonic, may have spastic or athetoid component, those that remain flaccid are the most severely mentally and physically affected of all children with CP. | |
| What are the deformities seen in flaccid CP? | Hypermobile joints, risk for hip dislocations due to “frog leg” position, handle proximally. | |
| What are other signs associated with flaccid CP? | Decreased deep tendon reflexes. |
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