‫هَّٰلل‬

ِ ‫بِ ْس ِم ٱ ِ ٱلر َّْح ٰ َم ِن ٱلر‬

‫َّح ِيم‬
"In the name of God, the Most Gracious, the Most Merciful"
Cerebral Palsy
Presented By
Muqadas Ramzan
INTRODUCTION
• Cerebral: Having to do with brain

• Palsy: Weakness or problem with body movement

INTRODUCTION
• Neurological Disorder

• Can happen Before Birth, During Birth, and after Death

INTRODUCTION
Cerebral Palsy is a group of permanent, but not unchanging,
disorders of movement and/or posture and of motor function,
which are due to a non-progressive interference, lesion, or
abnormality of the developing/immature brain
Signs and Symptoms 
 
Causes
Cerebral palsy is usually caused by a problem that affects the
development of a baby's brain while it's growing in the womb.

These include:

• Damage to part of the brain called white matter, possibly as a

result of a reduced blood or oxygen supply – this is known
as periventricular lukomalcia an infection caught by the
mother – such as cytomeglovirus, rubella, chickenpox or
toxoplamosis a stroke – where there's bleeding in the baby's
brain or the blood supply to their brain is cut off

• An injury to the unborn baby's head

Causes
Types
Differential Diagnosis
• Slowly progressive conditions that may present similarly to CP, including
familial paraplegia (presents as spastic diplegia) and some of the
leukodystrophies. Brain MRI and serial observations over time will help
differentiate these conditions.

• Genetic syndromes causing developmental delay, which may become more

obvious as the child ages (e.g., developmental delay, poor feeding, and
hypotonia in an infant with Prader-Willi syndrome).

• Metabolic disease that may present with CP-like symptoms, but also may
include developmental regression, periods of emesis and dehydration, and
failure to thrive.

• Neuromuscular conditions that appear early in life similar to CP. The

absence of reflexes, bowel and bladder dysfunction, and muscle weakness
(sometimes difficult to differentiate from low tone) should distinguish
these.
Diagnosis
• History
• Examination
• X-Ray Skull Intracranial Calcification
• EEG
• CT/ MRI
• Test of hearing, vision
• IQ Test
Diagnosis
Clinical diagnosis of cerebral palsy is based on the pattern of abnormalities
on neurologic examination:-

P – Abnormal Posture: fisting with adducted thumbs, hyperextension and

adduction (scissoring) of lower extremities, and hyperextension of trunk
(arching).
O – Poor Oral-motor coordination: poor sucking-swallow coordination, poor
lip closure on the nipple, difficulty handling textured foods, or excessive
drooling. Older kids may have trouble with drooling, chewing or articulation.
S – Strabismus: abnormal alignment of the eyes, commonly associated with
cerebral palsy.
T – Abnormal muscle Tone: increased resistance to passive movement of the
extremities and decreased axial tone.
E – Delayed integration of primitive reflexes, delayed Evolution of automatic
responses: persistent palmar grasp, Moro, asymmetric tonic neck reflexes.
Poor equilibrium, delayed protective response.
R – Deep tendon Reflexes: brisk, with clonus.
Treatment
Physical Therapy Management

• Passive Stretching
• Weight Bearing
• Splinting
• Serial Casting
• Static-Weight bearing exercises
• Muscle Strengthening Exercises
• Functional Exercises
• Body Weight Supported Treadmill Training
• Electrical Stimulation
• Neurodevelopment Technique
• Constrained Induced Movement Therapy
Cont..
• Range of Motion Exercises
• Hippo therapy
• Gait Training
• Aquatic Therapy
• Bridging Exercises
Physical Therapy Management
Physical Therapy Management
Thank You!