Paralisis cerebral

CEREBRAL PALSY
DESCRIPTION
Cerebral Palsy (CP): is defined as a group of permanent motor syndromes that occur as a result of disorder of early brain development. The condition involves motordisorders; disturbances of sensation, perception, communication, cognition, and behavior; secondary musculoskeletal problems; and epilepsy. The primary disturbance includes abnormal muscle tone andcoordination. The majority of children with CP, however, do not have significant cognitive dysfunction.
PATHOPHYSIOLOGY
The exact mechanism that causes the neurologic brain lesions of CP is often noidentified. Some children with CP have congenital malformation of the brain; other may have evidence of vascular occlusion, atrophy, loss of neurons, and degeneration. Hypoxic infraction or hemorrhageadjacent to the lateral ventricles is often identified as a cause of CP. Ataxic CP may occur in relation to cerebral hypoplasia and, in some cases, severe hypoglycemia. Additional antenatal factor thatcontribute to CP include maternal chorioamnionitis, inflammation of placental membranes, umbilical cord inflammation, maternal sepsis, elevated maternal temperature prior to delivery, and urinary tractinfection; however, not all infants born to mothers with these clinical signs will develop CP. Preterm birth, low birth weight (less than 1000 grams), and the occurrence of intracerebral hemorrhage andperiventricular leukomalacia are associated with an increased incidence of CP.
CLINICAL SIGNS AND SYMPTOMS
Spastic type
* Increased muscle tone (hypertonicity)
* Increased deep tendonreflexes and clonus
* Flexor, adductor, and internal rotator muscles more involved than extensor, adductor, and external rotator muscle
* Difficulty with fine and gross motor skills
*Contracture of the heel cord
* Hip adductor contractures leading to progressive hip subluxation and dislocation
* Knee contractures
* Scoliosis
* Typical gait is crouched, in toeing ,...