(CP)

Submitted to:
Mr. Francis Onayan

Submitted by:
Karen P. Fadullan
After the discussion, the whole class will be
able to:

◦ Know what is cerebral palsy

◦ Identify different clinical manifestations (signs and
symptoms) and appropriate assessment for cerebral
palsy
◦ State the different risk factors for CP
◦ Know what are the different therapeutic and nursing
management for cerebral palsy
 Is a neuro-developmental impairment caused
by a non-progressive defect or lesion in single
or multiple locations in the immature brain
 This defect causes cognitive and motor

impairment and possible sensory deficits that

are usually evident in early childhood.
 Cerebral refers to the “cerebrum”, and palsy

refers to disorder of movement

 The most common clinical manifestation in all
types of CP is delayed gross motor development.

 Additional manifestations include:

◦ Abnormal motor performance
◦ Alterations of muscle tone
◦ Abnormal postures
◦ Reflex abnormalities

Disabilities associated with cerebral palsy

include mental retardation, seizures, attention
deficit disorder and sensory impairment.
 Infants at the highest risk for developing
cerebral palsy exhibit one or more of these
factors:
 Premature
 Low birth weight (<5lb)
 Do not cry within 5 minutes of delivery
 Sustained on a ventilator more than 4

weeks
 Brain hemorrhage
1.) Spastic CP

◦ Is the most
common type of
cerebral palsy. It
causes the muscles
to be stiff and
permanently
contracted.
 a.) Diplegia

- either both arms

or both legs
- The legs often
turn in and cross at
the knees. This
causes a scissors
gait.
 b.) Hemiplegia
(hemiparesis)

- limbs on only one

side of the body
- persons having this
condition may also
experience
hemiparetic
tremors
 c.) Quadriplegia

- all four limbs are

affected
- there is dysfunction of
the muscles of the mouth
and tongue, seizures,
medical complications,
and increased risk for
cognitive difficulties
- The muscles of the face
and tongue may be
affected, causing
grimacing and/or drooling.
2.) Dyskinetic or
athetoid

- is characterized by slow, uncontrolled,

writhing movements of the hands, feet,
arms or legs (athetosis)
 3.) Ataxic CP

- affects balance
and depth
perception

- Persons having this

condition have poor
coordination and
walk unsteadily
 4.) Mixed CP

- Involves two or more types of cerebral palsy

 A multidisciplinary team of healthcare professionals develops an
individualized treatment plan based on the patient’s needs and problems.

THERAPY:

 Physical therapy
– Daily range of motion exercises help prevent muscles from growing
weak and atrophied or rigidly fixed from contracture
 Speech therapy
– Children with athetoid CP often have trouble pronouncing words
(dysarthia), and swallowing (dysphagia).
- This will help the child to swallow and facilitate communication
 Psychotherapy
– Praise, positive reinforcement, and small rewards can encourage a
child to learn to use weak limbs, overcome speech deficits, and stop
negative behaviors.
 MEDICATIONS
Goal: reduce the effects of cerebral palsy and
prevent complications

Medications used to relieve spasticity and

abnormal movements include the following:
◦ Dopaminergic drugs : decrease rigidity and
abnormal movements(e.g.levodopa/carbidopa
and trihexyphenidyl)
◦ Muscle relaxants : reduce spasticity by relaxing
the muscle directly (e.g. baclofen)
◦ Benzodiazepines : act on brain chemistry to
relax muscles. (e.g. diazepam – most widely used)
  Deficient knowledge related to understanding of
complex disease condition.
 Risk for disuse syndrome related to spasticity of
muscle groups.
 Risk for self-care deficit related to impaired
mobility.
 Risk for delayed growth and development related to
activity restriction secondary to CP.
 Risk for imbalanced nutrition, less than body
requirements, related to difficulty sucking in
infancy or difficulty feeding self in an older child.
 Impaired verbal communication related to
neurologic impairment.