- Leading cause of childhood disability effecting function and development.
- Defined as a group of disorders involving motor or postural abnormalities that are noted during early development
- Injury occurs during fetal or neonatal period up to 3 yrs. Official diagnosis may not be made until 3 years of age
- Associated with
- Spastic cerebral palsy is the most common type, ~80% of cases
Spastic diplegia (30-40%)
- Bilateral lower extremities effected more than upper extremities or sole involvement of lower extremities.
Spastic hemiplegia (20-30%)
- One side of the body effected, including an upper and lower extremity
- Upper extremity spasticity effected more than lower extremity
- Double hemiplegia: when both arms are more involved than the legs
Spastic quadriplegia (10-15%)
- Cerebral palsy affecting all 4 extremities and the trunk (full body)
Dyskinetic cerebral palsy
- Athetoid, choreoathetoid, and dystonic
- Extrapyramidal signs characterized by abnormal movements; hypertonicity
Mixed cerebral palsy
- Mixture of spastic and dyskinetic components without predominant area
Hypotonic cerebral palsy
- Rare: Truncal and extremity hypotonia with hyperreflexia and persistent primitive reflexes
- Rare: One limb involved, either an arm or a leg
- Must rule out other causes.
- Abnormal muscle tone (most common)
- Hypertonia > hypotonia
- Intellectual disability (30-50%)
- Speech and language impairment
- Ophthalmologic impairment
- Hearing impairment
- Oromotor dysfunction
- Disease classified according to resting tone and limb involvement
- Neuromuscular weakness
- Spinal cord disease:
- Peripheral nerve disease:
- NMJ disease:
- Muscle disease:
- Non-neuromuscular weakness
- Rule out Baclofen withdrawal in patient being treated for spasticity with Baclofen pump.
- Mutch L, Alberman E, Hagberg B, Kodama K, Perat MV. Cerebral palsy epidemiology: where are we now and where are we going?. Dev Med Child Neurol. 1992 Jun. 34(6):547-51.
- Shevell MI, Bodensteiner JB. Cerebral palsy: defining the problem. Semin Pediatr Neurol. 2004 Mar. 11(1):2-4.
- Stanley F, Blair E, Alberman E. Cerebal Palsies: Epidemiology and Causal Pathways. London, United Kingdom: MacKeith Press; 2000
- Russman BS, Ashwal S. Evaluation of the child with cerebral palsy. Semin Pediatr Neurol. 2004 Mar. 11(1):47-57.