113 Cerebral Palsy

True or False: Cerebral Palsy is a genetic defect.

• True

• False

Answer explanation

It occurs due to injury/insult to developing brain, not genetics!

- Spastic (80%), Dyskinetic, Ataxic, mxed

Which of the following are risk factors for hypoxic brain injury during birth or after birth? (Select all that apply)

• Drug use

• Cord compression

• Long birth process

• Trauma from falls

• Maternal infection

Answer explanation

Abnormal Fetal Development of the brain:

- Drug use

- Maternal hypoxia

- Placental abruption or any placental issues

- Cord compression

- Maternal infection

-Pre term delivery & its causes

Hypoxic brain injury during birth or after birth

- Cord compression, long birth process, infant apnea at birth, trauma from falls

What are sever signs & symptoms of CP? (Select all that apply)

• Impaired gait

• Impaired swallowing

• Impaired speech

• Hypertonicity

• Impaired vision & hearing

Answer explanation

Mores severe cases:

- Intellectual disability

- Seizures

- Impaired swallowing

- Impaired speech, vision, and hearing

Regular S&S: Lack of coordination, impaired gait, hypertonicity, abnormal posturing

What are treatments for CP? (Select all that apply)

• PT, OT, Speech Therapy

• Braces & splints

• Serial casting

• Surgeries

Answer explanation

Surgeries: lengthen Achilles tendon, hamstring release, improve hip adduction, correct position of foot

Which drug has the side effect of muscle weakness, fatigue, diaphoresis, HAs, nausea, constipation

• Baclofen

• Diazepam

• Botulinum Toxin A

Answer explanation

Baclofen - skeletal muscle relaxant

Diazepam - SE of drowsiness, fatigue, etc.

Botox A - IM injection, works to inhibit Ach; Monitor temporary weakness & pain

True or False: Botox A can be used immediately to treat symptoms.

• True

• False

Answer explanation

Onset 24-72 hrs

Therapeutic effects peaks in 2 weeks.

Lasts 3-6 months.

Used more for maintenance.

A nurse is assessing a 5 month old infant for CP. Which of the following findings could be a manifestation of the condition?

• Patient is unable to walk

• Patient is unable to crawl

• Patient is unable to sit up

• Patient is unable to roll over

• Patient is able to control neck

Answer explanation

Since pt is 5 months old he should be able to roll over, but since he cannot, it could be signs of CP or developmental delay.

2 mo = Head (should control neck)

4 mo = Shoulders (roll over)

6 mo = Hips (Sit up unassisted)

8 mo = Knees (Crawl)

12-14 mo = Toes (Walk)