Introduction

Cerebral palsy may be defined as a disorder of movement and posture due to a non-progressive lesion of the motor pathways in the developing brain. It affects 2 in 1,000 live births and is the most common cause of major motor impairment

Classification

Classification
  • spastic (70%): hemiplegia, diplegia or quadriplegia
  • dyskinetic
  • ataxic
  • mixed

Aetiology

Causes
  • antenatal (80%): e.g. cerebral malformation and congenital infection (rubella, toxoplasmosis, CMV)
  • intrapartum (10%): birth asphyxia/trauma
  • postnatal (10%): intraventricular haemorrhage, meningitis, head-trauma

Clinical features

Possible manifestations include:
  • abnormal tone early infancy
  • delayed motor milestones
  • abnormal gait
  • feeding difficultie.

Children with cerebral palsy often have associated non-motor problems such as:
  • learning difficulties (60%)
  • epilepsy (30%)
  • squints (30%)
  • hearing impairment (20%)

Management

Management
  • as with any child with a chronic condition a multidisciplinary approach is needed
  • treatments for spasticity include oral diazepam, oral and intrathecal baclofen, botulinum toxin type A, orthopaedic surgery and selective dorsal rhizotomy
  • anticonvulsants, analgesia as required