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Cerebral Palsy. H.Makhmalbaf MD Consultant Knee Surgeon. Cerebral palsy. Description Prenatally ,30% Perinatally ,60% Postnatally ,10%. Epidemiology. 0.6-5.9 patients in 1000 live births Prenatal care Socioeconomic condition of parents
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Cerebral Palsy H.Makhmalbaf MD Consultant Knee Surgeon
Cerebral palsy • Description • Prenatally ,30% • Perinatally ,60% • Postnatally ,10%
Epidemiology • 0.6-5.9 patients in 1000 live births • Prenatal care • Socioeconomic condition of parents • Type of obstetric &pediatric care the mother & child receive • In the USA 2/1000 live births • NICU ,low birth weight
Types of CP • Spastic 65% injury to pyramidal tracts • Athetosis is a type of dyskinesia ,injury to extrapyramidal brain lesion • Dystonic Athetosis ,choreiform • rigid athetosis • Ataxic • Mixed ,both pyramidal & extra
Types of CP • If the lesion is in the cortex • Midbrain or base of the brain • Cerebellum ,ataxia • Widespread brain involvement
studies • Cerebral blood flow • CT • US • MRI • In the NICU’s
Prenatal causes • Congenital brain defect • Mother had rubella or viral infection • Erythroblastosis fetalis • Fetal anoxia • Maternal cardiovascular disease • Alcohol ,diabetes mellitus ,thyroid abnorm
Natal causes • Trauma or asphyxia • Trauma ,internal cerebral hemorrhage • In eclampsia • Delay in delivery • Fetal aspiration • Anaesthetic complications • Prematurity
Postnatal causes • Encephalitis • Meningitis • Trauma ,head injuries • Vascular accidents • Asphyxia • Prevention • immunization ,antibiotics
Clinical types • Or geographic classification • Monoplegia • Hemiplegic • Diplegia • Quadriplegia
Diagnosis • Newborn or childhood • Developmental delay • Tests • Reflexes
Deformities • Spine • Shoulder • Elbow • Wrist • Hip ,knee ,ankle
Treatment • Physical independence • Commiunication • Mobility ,activity of daily life • Ambulation • Surgical treatment