Cerebral Palsy Case Study

Cerebral Palsy
Introduction
Cerebral palsy is a group of disorders affecting movement and

posture, resulting from
damage to the developing brain, typically occurring before birth. The
severity of the symptoms
can range from extremely mild to severe and usually manifest during
infancy or preschool.
Children with cerebral palsy may exhibit exaggerated reflexes and
floppy appearances in the arms,
legs, and trunk or stiff muscles, known as spasticity. Additional
symptoms can include abnormal
posture, involuntary movements, an unsteady gait, or a combination.
Cerebral palsy may also
impair swallowing and cause eye muscle imbalance, preventing the
eyes from focusing on the
same object. Muscle stiffness can lead to a reduced range of motion in
the joints. The causes and
functional impacts of cerebral palsy vary between individuals. Some
people with the condition can
walk unaided, while others require assistance. Intellectual disabilities
may be present in some
individuals, but not in others. Additionally, cerebral palsy can be
associated with epilepsy,
blindness, or deafness. Although there is no cure for cerebral palsy,
treatments can help improve
function. While symptoms may change as a child grows, the condition
does not worsen over time,
it remains generally stable.
Pathophysiology
Precipitating Factors
Pregnant
 Exposure to radiation and toxins,
drugs, viral or bacterial in the
central nervous system during 1st
trimester.
Infant/Child
 Head injury
 Infections such as meningitis and
encephalitis
Predisposing Factors
Pregnant
 Placental complication such as
placenta previa and abruptio placenta
 Multiple births
 Maternal bleeding
Fetus/Infant
 Breech presentation
 Prematurity
 ABO/Rh incompatibility
 Low birth weight
Premature brain
development or
malformation during
uterine life
Prolonged labor and
maternal complications
during birth
Inflammatory process
within the CNS during
childhood
Underdevelopment of Decrease oxygen supply to the brain
certain part of the brain
Brain tissue necrosis
Neurologic lesion formations in the motor

areas of the brain
Underdeveloped or
disrupted corticospinal
tract
Underdeveloped or
disrupted cerebellum
Underdeveloped or
disrupted extra pyramidal
motor system
Impaired
GABA
absorptio
n in the
nerves
affected
Hyperton
ia of the
muscles
Partial/co
mplete
loss of
control of
voluntary
body
posture
adjustme
nts
Suppressi
on of
proprioce
ptive
responses
Disruptio
n of
brain’s
ability to
integrate
sensory
perceptio
n
Impaired
ability to
coordinat
e motor
control
Disruptio
n of brain
ability to
integrate
coordinat
ion and
muscle
control
Impaired
or
disrupted
corticobu
lbar tract
Partial/co
mplete
loss of
facial and
jaw
musculat
ure,
swallowi
ng and
tonguemo
vements
Impaired
or
disrupted
basal
ganglia
Disruptio
n with the
brain's
ability to
choose
what
behaviour
to carry
out.
Spastic Cerebral Palsy Ataxic Cerebral Palsy Athetoid/Dyskinetic
Cerebral Palsy
Diagnostic Procedures
Diagnosis is done clinically, however, laboratory may be rule out other
conditions in some
cases. Neurologists or neuroradiologists commonly employ
neuroimaging techniques such as
cranial ultrasound, computed tomography (CT) scans, and magnetic
resonance imaging (MRI)
scans. These tests enable neurologists to visually examine the brain.
Different disorders, injuries,
and conditions produce distinct results, which can help rule out
cerebral palsy or, if diagnosed,
offer a precise image of the brain injury. Additionally, any seizure
activity will be monitored if it
is present.
Nursing Management
Nursing care plans for patients with cerebral palsy may focus on
enhancing mobility and
independence, promoting nutrition and growth, promoting effective
communication, preventing
complications and injuries, and offering support and education to both
the patient and their
caregivers. Facilitating the patient's development and attending to any
psychosocial and emotional
needs associated with their illness could be additional objectives.
Medical/Surgical Management
Cerebral palsy patients may need lifelong assistance from a medical
team. It is not possible
to cure cerebral palsy, on the other hand, a variety of therapeutic
choices could enhance the
patient's capacity for everyday life. The child's specific symptoms and
needs—which could change
over time—will determine which kind of care is most effective. Results
can be improved with
early intervention. Medication, therapy, surgery, and other procedures
are all possible forms of
treatment, if necessary.
Medical management is the use of different medications according to
the individual needs
of the patient. Baclofen and diazepam are examples of antispasmodics
that are prescribed to treat
muscle spasticity, whereas anticholinergic are used to treat aberrant
movements. Patients with
cerebral palsy frequently experience seizures, which are treated with
anticonvulsants. Moreover,
muscle relaxants can reduce muscle tension and increase movement.
In order to lessen discomfort,
analgesic pain management is also crucial. Therapeutic interventions
play a crucial role in the
management plan. Physical therapy aims to improve strength,
flexibility, balance, and motor skills.
Occupational therapy focuses on enhancing daily living skills and
promoting independence.
Speech therapy assists with communication difficulties and swallowing
issues. Orthotic devices, such as braces and splints, support the limbs
and improve mobility. Assistive devices, including
wheelchairs, walkers, and communication aids for non-verbal patients,
further aid in improving
the patient's quality of life. Nutritional support through specialized
diets and feeding techniques is
provided for those with swallowing difficulties. Surgical management is
considered for more
severe cases where medical therapy alone is insufficient. Orthopedic
surgeries, such as muscle and
tendon lengthening, help improve mobility and reduce contractures.
Spinal surgeries may be
necessary for severe scoliosis or other spinal deformities, and hip
surgeries can correct dislocations
and enhance joint function. Neurosurgical interventions include
selective dorsal rhizotomy (SDR),
which reduces spasticity by severing nerve fibers that contribute to
muscle stiffness, and intrathecal
baclofen therapy (ITB), which involves implanting a pump to deliver
medication directly to the
spinal cord, thereby reducing spasticity. Gastroenterological surgeries,
such as gastrostomy tube
placement, ensure adequate nutrition for patients with significant
swallowing difficulties.
Prognosis
Most children with cerebral palsy have a favorable prognosis and can
anticipate living well
into adulthood. On average, individuals born with cerebral palsy can
expect a lifespan ranging
from 30 to 70 years. Those with the longest life expectancies typically
benefit from greater
mobility, better medical care, and the use of adaptive equipment. They
also enjoy higher levels of
autonomy and independence.

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Cerebral Palsy

Cerebral palsy is a group of disorders affecting movement and

Neurologic lesion formations in the motor

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