User Name Password Remember Me  
 
 
   
Video Podcast
Audio Cast
Mobile(WAP)
  Pedi Poll  
Is childhood obesity on the rise? Are children becoming fatter?
Yes
No
  Translate This Page  
 
Early Diagnosis Of Cerebral Palsy
ASSAM PEDICON 2007, SILCHAR, 22-23 December 2007

Dr. J. N. Sharma
Prof. & Head Deptt. of Pediatrics
Guwahati Medical College


Definition:

Cerebral palsy is a persistent disorder of posture and/or movement, due to a non-progressive damage to the developing brain.

The upper age limit of brain insult is not strictly defined

Arbitrarily fixed at 5 yrs by AAP.

Cerebral Palsy : Classification

A standardized method of blood pressure measurement is the most essential prerequisite of defining HTP. Auscultator method is the gold standard of all methods with available normative data for sex, age and height. It consists of the following steps in succession:
  • Type of motor disorder
    Spasticity
    Athetosis
    Rigidity
    Ataxia
    Hypotonia
    Mixed
  • Anatomical distribution
    Diplegia
    Tetraplegia
    Triplegia
    Hemiplegia
    Monoplegia
  • Severity
    Mild, Moderate, severe
Major risk factors:
    Prematurity (75 fold)/VLBW
    Exposure to disrupted brain perfusion/oxygenation in fetal, natal, neonatal period
    Birth asphyxia (10%)
    Apgar score 3 or less a 20 minutes (250 fold increased risk)
    Postnatal causes (18%)
Minor Risk Factors:
    Mother 40 years or older
    Mother 20 years or younger
    Father 20 years or younger
    First born or 5th or later born
    Twin
    Birth weight < 1.5 kg.
    Gestation < 37 weeks
Risk factors:
    Rh or ABO incompatibility
    IU Infection in early pregnancy (German Measles)
    CNS infection of the infant
    18% of CP is acquired afterbirth (meningitis, head trauma)
Follow up:
    High risk newborns
    Need regular follow-up and neurodevelopmental examination
    From birth onwards
    For early detection and intervention
Early diagnosis:
    Early neuromotor behavior
    Milestones
    Neurodevelopmental assessment
    Corrected age for preterm for assessment.
Early neuromotor behavior:
    Lack of alertness and poverty of movements, poor sleep
    Excessive crying
    Kicks both legs together
    Constant fisting and adduction of thumb
    Primitive reflexes beyond 6 months
    Obligatory ATN reflex
    Delayed milestones
Milestones:
    Social smile : 2 months completed
    Holds head steady : 4 months completed
    Sits alone : 8 months completed
    Stands alone : 12 months completed
    Delayed milestones
    Abnormal neuromotor behavior
    Referral for neurodevelopmental assessment
Neurodevelopmental assessment:
    Infant motor screen
    Amiel Tison method
    Trivandrum developmental screening chart (TDSC)
Amiel Tison method:
    Steps of examination
    Examination of the head : sutures, fontanelle and head circumference.
    Sensory development : Visual pursuit and acoustic blink reflex.
Assessment of muscle tone:
    Spontaneous posture
    Is observed when the baby lies undisturbed. Look for constant closure of hands and asymmetry of face or limbs.
Active tone:
    Is studied with the infant moving spontaneously in response to a given stimulus e.g., pull to sit. In addition to tone, reflexes viz., stepping and placing reflexes, parachute reflex, knee jerk and ankle clonus are to be examined.
Passive one is studied by:
    Adductor angle
    Heal to ear angle
    Popliteal angle
    Dorsiflexion angle of foot
    Scarf sign
Conclusion:

Early diagnosis and early intervention
Is the corner stone for effective rehabilitation of these children
To help them live a quality life.

Last Updated on 15-02-2008

How to cite this url
Assam Pedicon 2008 - Conference Abstracts.Pediatric Oncall [serial online] 2008 [cited 15 February 2008(Supplement 2)];5. Available from:
http://www.pediatriconcall.com/fordoctor/Conference_abstracts/
assampedicon2007/diagnosis_cerebralpalsy.asp
 
  Search  
Hospitals
Pediatrician
Special Schools
Medical Colleges
Pediatric Conferences
Jobs & Vacancies
Journals
  Ped Tools  
Pediatric Calculator
Drug Index
Medical Equipment
Vaccine Reminder
Adverse Drug Reactions
Biochemical Profile
  Calculators  
+ Serum Osmolality
+ A-a Gradient
+ Bicarbonate & Base
    Excess
+ Basal Metabolic Rate
+ Body Mass Index
+ Body Surface Area
+ Height
+ Weight
+ Head Circum.
+ Predict Height
 
 
Parent Corner l Kids Corner l Terms & Condition | Privacy Statement l Advertising l Feedback l Awards
About Us
l Link to Us l Site Map l Shopping Mall  
Partner Sites
 HIV in Children  Infection in Children  Pedcall  Medical ADRIS  Vaccine Reminder  Pediatric Oncall Journal

Copyright© 2000-2008 All rights reserved with Pediatric Oncall

Disclaimer:The information given by www.pediatriconcall.com is provided by medical and paramedical & Health providers voluntarily for display & is meant only for informational purpose. The site does not guarantee the accuracy or authenticity of the information. Use of any information is solely at the user's own risk. The appearance of advertisement or product information in the various section in the website does not constitue an endorsement or approval by Pediatric Oncall of the quality or value of the said product or of claims made by its manufacturer.

 
Sitemap For Doctor | Sitemap For Parent | Sitemap For Kids Site designed and maintained by Levioza