1. CEREBRAL PALSY AND ITS
TREATMENTS
Mindy Gambino
ENG 333

2. Overview
BACKGROUND

 TYPES, CAUSES AND SYMPTOMS
 TREATMENTS

3. CEREBRAL PALSY
Non curable, non progressive disorder

 Affects the ability to move
 Affects posture and balance

4. Types of Cerebral Palsy
Spastic

 Athetoid
 Ataxic
 Mixed

5. SPASTIC CP
Tense, contracted muscles

 Most common
◦ Affects 70-80% of all CP patients
Stiff, awkward movements

 Difficulty shifting positions

6. SPASTIC CP (Cont.)
Three subtypes

1. Diplegia – affects one side
2. Hemiplegic – affects both arms/both
legs
3. Quadriplegia – affects all limbs
Spastic CP is caused by damage to

the motor cortex

7. ATHETOID
Uncontrolled motion in face, arms, and

trunk
 Movements may increase with stress
and dissipate during sleep
 Interferes with coordinated
movements
 Caused by damage to the cerebellum

8. ATAXIC CP
Poor balance resulting in stumbles

and falls
 Caused by damage to the cerebellum
 10% of CP patients have this form

9. MIXED CP
Spastic, involuntary movements

 Combinations of the previously
mentioned types
 Damage to both the motor cortex and
cerebellum
 25% of CP patients have this form

10. CAUSES OF CP
Developmental malformations

 Neurological damage
 Brain damage occurring before, during
or after birth

11. DEVELOPMENTAL
MALFORMATIONS
Failure of the brain to develop

correctly
 Lower than normal number of brain
cells
 Fetal brain cells not migrating to
correct areas

12. NEUROLOGICAL DAMAGE
Before , during or after birth


13. NEUROLOGICAL DAMAGE
Three main causes before and during

birth
◦ RH incompatibility
 Blood conflict between the mother and fetus
◦ Illness of the mother
 Viral diseases
 Poor nutrition
 Diabetes
 Alcohol or drugs

14. NEUROLOGICAL DAMAGE
(Cont.)
Severe Lack of Oxygen

◦ Premature Separation of the placenta
from the uterine wall
◦ Breach birth
◦ Interference with circulation of the
umbilical cord

15. NEUROLOGICAL DAMAGE
(Cont.)
After Birth Causes of CP
 Accidental Injury
 Lead Poisoning
 Illness
◦ Meningitis
◦ Encephalitis

16. SYMPTOMS OF CP
Usually noticeable before age three

 Two main
◦ Physical
◦ Behavioral

17. PHYSICAL SYMPTOMS OF
CP
Difficulty sucking

 Poor muscle control
 Poor coordination
 Muscle spasms and seizures
 Developmental delays in:
◦ Crawling
◦ Sitting
◦ Walking

18. BEHAVIORAL SYMPTOMS OF
CP
Unusual tenseness

 Irritability
 Lack of concentration
 Emotional Problems
 Sometimes Down Syndrome

19. TREATMENT FOR CP
Orthopedic Surgery

 Orthotics
 Drug Therapies
 Physical and Occupational Therapy

20. ORTHOPEDIC SURGERY
Corrects muscle and bone deformities

caused by spasms
 Can be done at any age, usually from
age four

21. ORTHOPEDIC SURGERY
(Cont.)
Benefits
 Significant improvement in walking
 Improved range of motion
 Decreased deformity

22. ORTHOPEDIC SURGERY
(Cont.)
Drawbacks
 Time consuming
 25% chance of infection
 Child may temporarily regress
 Costly - $20,000 or more

23. ORTHOTICS
Known as braces

 Reduces plasticity
 Stretches tight muscles and holds
them to prevent contracture
 May improve walking

24. DRUG THERAPIES
Botox injections

 Inthrethecal baclofen

25. BOTOX INJECTIONS
Injected into the spastic muscle

 Quick procedure – 5 minutes
 Used on a few muscle groups at a
time
 Lasts up to three months
 Used for spastic diplegia or spastic
quadraplegia

26. INTHRATHECAL BACLOFEN
Pump implanted in the abdomen to

distribute dose
 Delivered into the spinal fluid
 Refilled every three months
 Decreases spasms and blocks
abnormal nerve signals

27. INTHRATHECAL BACLOFEN
Increased muscle control

 Dosage can be adjusted
 5-10% risk of infection
 Risk of spinal fluid leaks
 High cost - $20-$25,000

28. SELECTIVE DORSAL
RHIZOTOMY
Neurosurgical treatment

 Nerves from brain to leg muscles are
exposed in the spinal cord
 30-50% of the top of each nerve is cut
off
 Permanent decrease in spasms
 For children between four and eight

29. SELECTIVE DORSAL
RHIZOTOMY (Cont.)
Risks
 Could decrease feeling in legs
 Extensive hospital say
 4-6 weeks of inpatient rehabilitation
 Expensive

30. SPEECH THERAPY
Non invasive

 Special devices such as a computer
with a voice synthesizer

31. OCCUPATIONAL THERAPY
Develops skills such as:

◦ Feeding
◦ Brushing teeth
◦ Dressing
Improves day to day living

 Boosts self-esteem

32. PHYSICAL THERAPY
Used in conjunction with other

treatments
 Prevents muscle weakening (atrophy)
 Helps prevent muscle contracture
 Improves motor development