Transcript: Cerebral Palsy is a group of disorders that can effect the brain and nervous system functions such as movement, learning, hearing, seeing, and thinking. The word cerebral means having to do with the brain. The word palsy means a weakness or problem in the way a person moves or positions his or her body. The history of Cerbral Palsy goes back to the 1860s when english surgeon, William Little, came across a puzzling condition effecting children. The condition made simple tasks such as walking much more difficult for the children it effected. After some research Little found that many of the children were born from premature or difficult deliveries. he believed that the extended amount of time spent in the birth canal resulted in lack of oxygen which caused vital brain tissue to become damaged. It wasn’t until 1897 that Little’s theory would be challenged. Sigmund Freud, world famous psychiatrist, disagreed with Little, saying that children with cerebral palsy were susceptible to other problems such as intellectual disability, visual disturbances, and seizures. Freud believed that the condition might stem back earlier in life, during the brain’s development in the womb. His studies were disregarded for a long time however. The actual cause of cerebral palsy is not always known even to this date but children would have a higher chance of delveloping cerebral palsy if they had bleeding in the brain, brain infections, a head injury, infections in their mother during pregnancy, or severe jaundice. Treatment Cerebral palsy differs from person to person and because of this there is no universal cure. But there are treatments and therapies to help the person with CP carry on an otherwise normal life. Because of this there are many different types of treatment, each one of the different types helps reach a certain goal such as, to improve mobility, control pain, prevent and manage complications, maximize independence, enhance social and peer interactions, maximize ability to communicate, increase learning potential, and enhance their quality-of-life. There are also many medications and surgeries to help. Genetic Testing So far there is not any genetic testing going on, although some studies have shown that cerebral palsy is much more abundant in America and in Asian areas. The History of Cerebral Palsy Cerebral Palsy effects 1 in every 278 children and 30% of those effected by cerebral palsy have seizures. cerebral palsy is a life-long disorder, but it does not affect a person's life expenctency. Diagnosis Prognosis What is Cerebral Palsy? they may also have eating and digestive problems such as difficulty sucking or feeding as infants, or chewing and swallowing as older children and adults Vomiting or constipation and may also have Increased drooling Slower growth Irregular breathing and Urinary problems there are several different types of CP. Spastic, Ataxic, and Athetoid. Spastic CP is associated tense contracted muscles. Ataxic CP causes a poor sense of balance often causing falls and stumbles. and children with Athetoid have uncontrollable, constant movement of their head, eyes, and other limbs. some symptoms that occur in other types of cerebral palsy are Abnormal movements like twisting, jerking, or writhing of the hands, feet, arms, or legs even while the child is awake, which gets worse during periods of stress Tremors Floppy muscles, especially when resting, and joints that move around more then normal Sypmtoms of Cerebral Palsy However it causes many complications such as Bone thinning or osteoporosis Bowel obstruction Hip dislocation and arthritis in the hip joint Injuries from falls Joint contractures Pneumonia caused by choking Poor nutrition some times reduced communication skills sometimes reduced intellect Scoliosis Seizures (in about 30% of patients) In order for a doctor to determine if a child had cerebral palsy they must test several things such as, reflexes, muscle tone, posture, coordination and other factors, all of which can develop over months or even years. The average age of diagnosis for spastic diplegia, a very common form of cerebral palsy, is 18 months. spastic cerebral palsy, the most common type, causes Muscles that are very tight and do not stretch. They may tighten up even more over time. Abnormal walk, their arms tuck in toward their sides, their knees cross or touch, and their legs make "scissor" movements,or may even walk on their toes Joints are tight and do not open up all the way this is called joint contracture. Muscle weakness or loss of movement in a group of muscles called paralysis. The symptoms may affect one arm or one leg, one side of the body, both legs, or all of their arms and legs decreased intelligence or learning disabilities are common, but intelligence can be normal they may develope speech problems Hearing or vision problems Seizures and Extreme pain, in most adults
Transcript: Cerebral Palsy Lauren Cox, Stanton Hinson, Renee Struwing, Jessica Weaver Pathophysiology •Cerebral palsy is caused by damage to a developing fetal or infant brain •70-80% of all cerebral palsy cases being prenatally •Risk factors linked to cerebral palsy o Infection, seizure disorder, thyroid disorder in the mother o Birth defects o Complications during labor and delivery o Low birth weight o Multiple births (twins) o Hypoxia before, during, after birth o Brain damage early in life, due to infection (ex. Meningitis), head injury, hypoxia, or bleeding o Child abuse Cerebral palsy: “group of permanent disorders of the development of movement and posture, causing activity limitation, that are attributed to nonprogressive disturbances that occurred on the developing fetal or infant brain.” (Hockenberry, Wilson 2009) Diagnosis oNo one test that firmly diagnoses C.P. oParental history -Medical interview -Lab Studies -Imaging Studies •Ultrasound •CT •MRI Clinical Manifestations Early signs of Cerebral Palsy •Failure to meet developmental milestones •Persistent primitive reflexes •Poor head control •Stiff or rigid arms or legs •Pushing away or arching back •Floppy or limp body structure •Using only one side of body •Feeding difficulties •Persistent gagging or choking when fed •Extreme irritability or crying •Failure to smile by 3 months •Lack of interest in surroundings 3 Types Spastic type Dyskinetic type Ataxic type Spastic type · Visual defects · Seizures · Developmental delay · Hypertonicity · Increased deep tendon reflexes · Difficulty with fine and gross motor skills · Heelcord contracture · Scoliosis common · Elbow, wrist, and fingers in flexed position with thumb adducted Dyskinetic type · Hearing Impairment · Purposeless, involuntary, uncontrollable movements of face and extremities · Increased movements with stress and voluntary movements Ataxic type · Disturbed coordination · Lack of equilibrium · Unsteady gait · Few orthopedic problems · Hyporeflexia · Muscles hypotonic · Speech slurred and jerky · Nystagmus Prognosis Life Expectancy •Eight factors are identified as areas of concern which have the capacity to shorten life span in cases of cerebral palsy. They are: -Number of impairments and key disabilities -Severity level -Mobility restrictions -Feeding difficulties -Seizures -Cognitive functioning -Visual acuity -Respiratory functioning No Cure Medications Antispasmodics Anticonvulsants Anticholinergics Stool softeners and mild laxatives Therapies Physical Occupational Speech Respiratory Educational Goals: Early diagnosis and intervention, optimize development, quality of life Surgeries Dorsal rhizotomy Implantation of Baclofen pump Stereotactic surgery Reconstructive surgery Tenotomy Hip/scoliosis correction. Non-Surgical Treatment Ankle-foot brace Wheel chair Bicycle walker Technology-communication, eye hand coordination, mobility, ambulation Community resources: UCP (Indianapolis), March of Dimes, Children's Neurobiological Solutions Foundation, Easter Seals, Pedal with Pete Foundation, Pathways Awareness. Concern for Family o Support groups and counseling o Teaching o Nursing responsibilities Psychosocial and Cultural Considerations oTreatment oCommunication oCultures Reference (2005). Social problems with cerebral palsy. Cerebral palsy source. Retrieved from http://www.cerebralpalsysource.com/About_CP/social_cp/index.html. Alvarez, Norberto M.D (2012). Cerebral palsy causes. Retrieved from http://www.emedicinehealth.com/cerebral_palsy/page2_em.htm. Alvarez, Norberto M.D. (2012). Cerebral palsy diagnosis. Retrieved from http://www.emedicinehealth.com/cerebral_palsy/page3_e,.htm. Alvarez, N. (2012). Cerebral Palsy Symptoms, Causes, Treatment. Retrieved from http:// www.emedicinehealth.com/cerebral_palsy/article_em.htm. Cerebral palsy foundation (2012). Signs and symptoms of cerebral palsy. Retrieved from http://cerebralpalsy.org/about-cerebral-palsy/symptoms/ Cerebral palsy foundation (2012). Signs and symptoms of cerebral palsy. Retrieved from http://cerebralpalsy.org/about-cerebral-palsy/symptoms/. Cerebral palsy foundation (2012). Life expectancy of cerebral palsy. Retrieved from http://cerebralpalsy.org/about-cerebral-palsy/life-expectancy-of-cerebral-palsy/. Healthwise (2010). Cerebral Palsy-Medications. Retrieved from http://children.webmd.com/tc/cerebral-palsy-medications. Hockenberry, M. (2008). Wong’s essentials of pediatric nursing (8th ed.). St. Louis: Mosby. Lehne, R. A. (2010). Pharmacology for Nursing Care (7th ed.). St. Louis, MO: Saunders. National Institute of Health (2012). Cerebral Palsy Information Page: National Institute of Neurological Disorders and Stroke (NINDS). Retrieved from http:www.ninds. nih.gov/disorders/cerebral_palsy.htm. Countdown What test firmly diagnoses cerebral palsy? 10 photo (cc) Malte Sörensen @ flickr 1. CT 2. MRI 3. No one test firmly diagnosis cerebral palsy 4, CBC 10 There is a new cure for cerebral palsy? a. An infectious disease of the central
Transcript: For up to date information on cerebral palsy, go to "The CP Blog." http://cerebralpalsy.org/blog/ CP Family Network was created for two reasons: 1) To provide information to all cerebral palsy families about diagnosis, treatments and resources for their child with CP. 2) If you suspect a birth error, to provide resources to help you uncover the truth. My Child Without Limits looks to provide parents of children with disabilities, their loved one’s best advocate, with the knowledge, resources, and network to ensure their future is without limits. Creating Inclusivity Articles Spastic cerebral palsy: this results in stiffness and difficulties in movement. Athetoid cerebral palsy: this results in involuntary movement. Ataxic cerebral palsy: this results in a weakened sense of balance and depth perception. Feeling embarrassed: In elementary school gym class, balance beam was like a total nightmare for me. But of course my gym teacher was totally oblivious. He was one of those people who thought that everybody should be treated equally. Nobody should wear glasses because that would be a disadvantage to the people with out glasses. That was his mind set. Well, the kids were ok with it, but it was still embarrassing because I always had to go up against this totally athletic kid, who is now the fastest runner in Massachusetts. So I’ve got competition there. And it’s like, ok, my turn. And yes, it is kind of embarrassing when I play soccer with people I don’t really know and they see that I kind of bob my head a little bit so they look at me like, is she having a seizure? - Ruby, 15 years old There are three types of cerebral palsy: http://experiencejournal.childrenshospital.org/?cat=23 Implications for Social and Emotional Well-being: "It about relationships: Perspectives of people with cerebral palsy." Schaller, James; De La Garza, Denise. Journal of Applied Rehabilitation Counseling: Summer 1999; 30, 2; ProQuest pg. 7. Websites Cerebral Palsy: A Brief Description •Give clear, brief directions. Give written or visual directions as well as oral ones. Allow extra time for oral responses. •Break tasks and assignments into short, easy-to-manage steps. Provide each step separately and give feedback along the way. •Provide checklists, graphic organizers, visual referents and examples to help the student plan ahead and to stay on-task. •Teach strategies for self-monitoring, such as making daily lists and personal checklists for areas of difficulty. •Use instructional strategies that include memory prompts. •Teach strategies for what to do while waiting for help (e.g., underline, highlight or rephrase directions; jot down key words or questions on sticky notes). •Provide extra time for tasks or reduce the amount of written work required. Ensure the student does not feel the pressure of activities being timed (tests, projects, classwork) •Provide alternatives to writing for the student to demonstrate learning (scrabble tiles, magnets, voice recordings). If handwriting continues to be difficult for the student, reduce expectations for copying, provide extra time for written work and explore the use of a dedicated word processor and writing software. •Use a buddy system for class activities or hands-on activities: arts and crafts, groups assignments, have a student share notes, or if the student is done early have them assist the student with their daily tasks KWL Chart You have to work really hard: Cerebral palsy is something that you get when you are born. And you, you use devices. Like, I use braces. You just use the device to help you walk better. And you have to do exercises and you just have to work really hard to get the goals that you want to get in your life. That’s basically what it is. - Madison, 10 years old "Neuroimpairments, activity performance, and participation in children with cerebralpalsy mainstreamed in elementary schools." Coster, Wendy J.; Parush, Shula; Schenker, Rony. Developmental Medicine & Child Neurology: 2005, 47: 808–814. "Participation and activity performance of students with cerebral palsy within the school environment." Coster, Wendy J.; Parush, Shula; Schenker, Rony. Disability and Rehabilitation: 2005; 27(10): 539 – 552. Resources to support and advocate for the child and their family What I Learned It is also good to develop goals tailored specifically to the student. Once the goal is met, create a new goal. That way the student is constantly working towards something. It helps to keep them motivated and helps them to better themselves. Classroom Adaptations for Students with Cerebral Palsy: Ideas to Help Teachers, Kristina Gavigan, April 28, 2009, http://voices.yahoo.com/classroom-adaptations-students-cerebral-palsy-3173780.html?cat=70 Cerebral Palsy: Medical/Disability Information for Classroom Teachers http://www.learnalberta.ca/content/inmdict/html/cerebral_palsy.html Education Techniques to Help Children with Cerebral Palsy in the Classroom, written by: Dr. Anne Zachry, edited by:
Transcript: 12-Step Diagnostic Process Muscles that are very tight and do not stretch. They may tighten up even more over time. Abnormal walk (gait): arms tucked in toward the sides, knees crossed or touching, legs make "scissors" movements, walk on the toes Joints are tight and do not open up all the way (called joint contracture) Muscle weakness or loss of movement in a group of muscles (paralysis) The symptoms may affect one arm or leg, one side of the body, both legs, or both arms and legs COMPLICATIONS Symptoms may vary depending on the person. (CP) Description Cerebral Palsy Cerebral Palsy is a group of disorders that affect a person's ability to move and maintain balance and posture. It is the most common motor disability in children. It is estimated that one in every 278 children have Cerebral Palsy. Step 1: Parental Observation Step 2: Clinical Observations Step 3: Motor Skill Development Analysis Step 4: Medical History Review Step 5: Documenting Associative Conditions, Co-Mitigating Factors, and Ruling-Out Other Conditions Step 6: Obtaining Test Results Step 7: Diagnosis Step 8: Obtaining Second Opinions Step 9: Determining Cause Step 10: Care Team Assembly Step 11: Care Plan Creation Step 12: Embracing a Life with Cerebral Palsy Contracture Malnutrition Depression Premature aging Post-impairment syndrome Osteoarthritis Signs & Symptoms DIAGNOSED
Transcript: Members of the Medical Team for Cerebral Palsy By Sidney Pollock Neurologists Developmental Behavior Specialist Developmental Behavior Specialists What do they do? What do they do? Developmental behavior specialists evaluate the patients developmental, cognitive, and behavioral issues They also provide the treatment plan along with a bunch of other doctors Geneticists Geneticists What do they do? What do they do? Geneticists try to figure out what may have caused the patients brain condition, because it could just be genes but it could be more. Additionally, they look over the genetic code to see if that had a factor in the cerebral palsy Neurological What do they do? What do they do? Neurologists are usually the ones to diagnose the patients condition They examine the patients posture, motor funtion, speech, muscle tone, strength, senses, reflexes, and coordination Physical, occupational, speech therapists Physical, occupational, and speech therapists Posters Posters
Transcript: Treatment There is no cure for cerebral palsy. The goal of treatment is to help the person to be as independent as possible. Treatment requires a team approach, including: primary care doctor, dentist(dental check-ups are recommended every six months), social worker, nurses, occupational, physical, and speech therapists, other specialists, including a neurologist, rehabilitation physician, pulmonologist, and gastroenterologist. Treatment is based on the person's symptoms and the need to prevent complications. Self and home care include: getting enough food and nutrition, keeping the home safe, performing exercises recommended by the health care providers, practicing proper bowel care(stool softeners, fluids, fiber, laxatives, regular bowel habits), protecting the joints from injury. Putting the child in regular schools is recommended , unless physical disabilities or mental development makes this impossible. Special education or schooling may help. There are items that may help with communication and learning, such as glasses, hearing aids, muscle and bone braces, walking aids, wheelchairs. Symptoms Cerebral palsy is caused by injuries or abnormalities of the brain. Most of these problems occur as the baby grows in the womb, bu they can happen at any time during the first two years of their life, while the baby's brain is still developing. In some people with cerebral palsy, parts of the brain are injured due to lack of oxygen in the area. Premature infants along with fetuses that are exposed to infections such as rubella (German Measles) have an increased rick of developing CP. Cerebral palsy may also occur during early infancy as a result of several conditions, including: bleeding in the brain, brain infections(encephalitis, meningitis, herpes simplex infections), head injury, infections in the mother during pregnancy(rubella), and severe jaundice. In some cases the cause of cerebral palsy is never determined. Cerebral palsy has many complications such as: bone thinning or osteoporosis, bowel obstruction, hip dislocation and arthritis in the hip joint, injuries from falls, joint contractures, pneumonia caused be choking, poor nutrition, reduced communications(sometimes), reduced intellect(sometimes), scoliosis, seizures(in about half of patient numbers), and social stigma. By: Ante and James Symptoms are usually seen before a child is two years old, and sometimes begin as early as three months. Parents may notice that their child is delayed in reaching, and in developmental stages such as sitting, rolling, crawling, or walking. Because there are many types of cerebral palsy, there are many symptoms but most are similar for each type. Common symptoms are: muscle weakness or loss of movement in a group of muscles(paralysis), abnormal movements such as twisting, jerking, or writhing of the hands, feet, arms, or legs while awake, which proceed to become worse in periods of stress, tremors, unsteady gait, loss of coordination, floppy muscles, especially at rest, and joints that move around too much. Other brain and nervous system symptoms include: decreased intelligence or learning disabilities, speech problems, hearing or vision problems, seizures, pain, especially in adults, which can be very difficult to manage. Other symptoms include: slower than normal growth, irregular breathing, urinary incontinence, eating and digestive problems such as problems swallowing, vomiting or constipation. Getting the proper prenatal care may reduce the risk of some rare causes of cerebral palsy. However, dramatic improvements in care over the last fifteen years have not reduced the rate of cerebral palsy. In most cases, the injury causing the disorder may not be preventable. Pregnant mothers with certain medical conditions may need to be followed in a high-risk prenatal clinic. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH00011734/?report=printable Peacock, Judith, Cerebral Palsy, LifeMatters, 2000 How to identify and diagnose Cerebral Palsy Bibliography WHAT IS CEREBRAL PALSY? Cerebral Palsy Prevention Cerebral Palsy is a group of disorders that can involve brain and nervous system functions, such as movement, learning, hearing, seeing, and thinking. There are several different types of cerebral palsy, including spastic, dyskinetic, ataxic, hypotonic, and mixed. The word "cerebral" refers to the brain. The word "palsy" refers to weakness of the muscles. The brain's motor centers normally control the muscles. The brain sends messages to the spinal cord. The spinal cord relays the messages to the nerves that lead to the muscles. People with cerebral palsy have motor problems because of damage to the brain's motor centers. A worst case scenario is when a child cannot control his/her muscles at all and will need to be looked after for the rest of their lives. There are many different types of cerebral palsy. Complications
Transcript: Cerebral Palsy cerebral pasly is: is from birth defects in the development of an infant or the early life of a child. Causes.. issues during pregnecy leady to abnormal brain conditions. speaking. a permanent condition that will not worsen with age. damaged or delayed development of te brain. vision problems. motor control tasks. Effects: writing. lack of oxygen to the brain due to premature birth. delivery room errors can cause brain damage. recognizable brain injury to a child. seizures. learning disabilities.
Transcript: Symptoms? Tests? Prevention? Cerebral Palsy Cerebral Palsy is a group of disorders that can involve the functions of the brain and nervous system, How and Who does is affect? http://kidshealth.org/teen/diseases_conditions/brain_nervous/story_cerebral_palsy.html Disease Project http://cerebralpalsy.org/about-cerebral-palsy/history-and-origin-of-cerebral-palsy/ Alissa Anderson & Victoria Hamby Extra Facts... It is not gender specific. A person's case can be either severe or mild depending on where the brain was damaged ad how much of the body that section controls. Babies are more likely to get cerebral palsy if the were born very under weight or prematurely. It may cause walking,talking,learning etc...Other complications could be seizures,osteoporosis,scoliosis,bad nutrition and more. It also affects someone emotional considering they may(depending on their case) have social problems. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001734/ http://www.cpparent.org/cpbooklet.htm The term 'cerebral' refers to the cerebrum of the brain, and 'palsy' describes any disorder that impairs control of body movement. In the mid-1800s, Dr. William John Little stated the study of cerebral palsy using his own childhood disability as an inspiration. Cerebral Palsy was fist known as Little's Disease, after William Little, to the man who discovered the facts of it. Little continued to practice medicine until 1884, but his dream did not end there. Two of his sons followed his footsteps into orthopedic surgery. At this time, it cannot be cured, although scientific research continues to improved treatments and methods of prevention. Around the age of 2 parents may notice that their child is slower in developmental stages that normal kids their ages should have already done(crawling,sitting,walking).A full neurological exam is very important, then other tests will be made like blood,vision,hearing etc...Getting prenatal care may help with rare causes, but the injury that doctors don't yet know what causes it, is not yet preventable. Once a child as cerebral palsy is is not reversible, however it can be made easier to deal with to have wheel chairs,walking aids,hearing aids, glasses etc... It isn't treatable itself, but most get related problems tat can be treated separately. What is It? Statistics? Occur? Cerebral Palsy is non- communicable disorder caused by an injury/abnormality to the brain as a baby. It can occur during first 2 years(head injuries,bleeding,infections,etc..), or while the baby was in the womb(due to not having enough oxygen the the brain-in the CEREBRAL!) Symptoms are usually seen before a child is 2 years old, and sometimes begin as early as 3 months. Cerebral Palsy is not heretic! The United Cerebral Palsy Associations estimate that more than 500,000 Americans have cerebral palsy. Despite advances in prevention and treatments, the number of children and adults it affects hasn't changed. It as possible even risen over the years. It is really based on race,gender,culture etc...
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