Cerebral palsy

Cerebral palsy
Definition:- A group of permanent disorders of movement and posture. Non progressive disturbances in the developing fetal or infant brain. Some movement disorders and orthopedic complications including scoliosis and hip dislocation, can change or progress over time. It is often associated with epilepsy, abnormalities of speech, vision, intellect, hearing and dental defect. May have no any sign of cognitive dysfunction.
Epidemiology: The incidence is 3.6/1000 with a male/female ratio of1.4/1.The prevalence of CP has increased due to the enhanced survival of very premature infants weighing <1,000 g, who go on to develop CP at a rate of approximately 15/100.
Etiology:-
1) Pre natal :- Congenital infections like (CMV , toxoplasmosis and rubella ), cerebral agenesis , intra uterine bleeding , radiation , toxins , anoxia , genetic and metabolic disorders ).
2)Perinatal:-( cerebral anoxia , intra ventricular hemorrhage , birth trauma).
3) Postnatal :-( meningitis , encephalitis , hyper biluribinemia , hypo glycemia , hyper natremia , subdural hematoma and toxins ).
Classification :-
1) Physiologic (spastic , rigid , athetoid , a taxic , a tonic , tremor , mixed , unclassified ).
2) Topographic : due to anatomical distribution (monoplegia , paraplegia , triplegia , quadriplegia , hemiplegia (arms > leg ) , double hemiplegie , diplegia ( legs > arms).
3) Functional
a) Class I ? no limitation of activity.
B) Class II ? slight – moderate limitation .
c) Class III ? moderate – severe limitation.
d) Class IV ? no useful physical activity.