Cerebral palsy
Description
Most common crippling neuromuscular disease in children
Comprises several neuromuscular disorders
Results from prenatal, perinatal, or postnatal central nervous system (CNS) damage
Three types (sometimes occurring in mixed forms):
spastic (affects about 70% of children with cerebral palsy)
athetoid (affects about 20%)
ataxic (affects about 10%)
Motor impairment minimal or severely disabling
Associated defects:
seizures
speech disorders
mental retardation
vision or hearing impairment
Prognosis varied
Highest in premature neonates and in those who are small for gestational age
Slightly more common in boys than in girls
More common in whites
Pathophysiology
A lesion or abnormality occurs in the early stages of brain development.
Structural and functional defects occur, impairing motor or cognitive function.
Defects may not be distinguishable until months after birth.
Causes
Conditions that result in cerebral anoxia, hemorrhage, or other CNS damage
Prenatal causes
Abnormal placental attachment
ABO blood type incompatibility
Anoxia
Irradiation
Isoimmunization
Malnutrition
Maternal diabetes
Maternal infection (especially rubella in the first trimester)
Rh factor incompatibility
Gestational hypertension
Parturition causes
Asphyxia from the cord wrapping around the neck
Depressed maternal vital signs from general or spinal anesthesia
Multiple births (neonates born last in a multiple birth have an especially high rate of cerebral palsy)
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