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Pediatric Imaging in General Radiography
Published in Christopher M. Hayre, William A. S. Cox, General Radiography, 2020
Allen Corrall, Joanna Fairhurst
Cerebral palsy describes a range of disabilities resulting from an insult during brain development. Depending on when in it occurs during neuronal development and the extent of the insult, the child can be hemiplegic with normal intelligence but often suffers with visual deficits and epilepsy; diplegic, which predominantly affects the lower limbs with normal levels of intelligence, or quadriplegic with varying levels of developmental, visual and occasionally oromotor impairments, and poor trunk control requiring supportive wheelchairs. The Gross Motor Function Classification System (GMFCS) is used to show the mobilizing abilities of the child. This ranges from mild motor control problems causing clumsiness but otherwise fully mobile through to spastic quadriplegia with little or no muscular control requiring splints and orthoses.
Cerebral palsy
Published in James Law, Alison Parkinson, Rashmin Tamhne, David Hall, Communication Difficulties in Childhood, 2017
Children with spastic quadriplegia (affecting all four limbs, the trunk, oral and pharyngeal muscles), who account for around 8% of the population, are often totally dependent. They frequently have severe learning difficulties, seizures and sensory impairments, which in combination with bulbar problems lead to profound communication impairments. Dyskinetic cerebral palsy (approximately 10%) is characterised by ¯uctuating tone throughout the body, often with involuntary movements. Bulbar problems are very common, often evidenced by early feeding difficulties, leading to dysarthric speech. The majority of children have normal intelligence or mild learning difficulties. Epilepsy or visual problems are not common.
The management of feeding in children with neurological problems
Published in Southall Angela, Feeding Problems in Children, 2017
Sheena. Reilly, Morgan. Angela, Alison. Wisbeach
Direct links have been made between reduced calorie intake and poor growth in children with cerebral palsy (Thommessan et al., 1991). Reduced body weight, body protein, linear growth, triceps and subscapular thickness have been found in the majority of children with spastic quadriplegia (Arrowsmith et al., 2006). There are a number of reasons why children with cerebral palsy have difficulty achieving an adequate nutritional intake; whilst adequate calories may be taken, there may be excessive loss due to vomiting and regurgitation (usually as a result of gastro- oesophageal reflux). Caloric intake may be inadequate; oral and pharyngeal function may be so poor that some children may take up to 18 times longer to eat a single mouthful of food. In such cases, even excessively long mealtimes will not compensate for the severity of the dysphagia (Gisel and Patrick, 1988). Whatever the cause, the resulting malnutrition has wide ranging effects that often go beyond physical growth. There may be neuro-developmental consequences for psychomo- tor development, and brain growth may be directly affected. Furthermore, there are recognised effects on the immune, skeletal and cardiovascular system (Rosenbloom and Sullivan, 1996).
Botulinum Toxin Type A in the Spasticity of Cerebral Palsy Related to Congenital Zika Syndrome: An Observational Study
Published in Developmental Neurorehabilitation, 2022
Giulia Armani-Franceschi, Cleber Luz, Pedro H. Lucena, Danilo d’Afonseca, Henrique Sales, Alessandra L. Carvalho, Isadora C. Siqueira, Karine Silva, Sandra Portuense, Larissa Monteiro, Igor D. Bandeira, Ailton Melo, Rita Lucena
The ZIKV epidemic in Brazil was accompanied by a substantial increase in cases of congenital microcephaly. Data regarding this cohort has recently been published and an analysis of the phenotype expression of the sample described so far, shows that most of the children suffering from brain injury have spastic quadriplegia cerebral palsy with early signs of poor motor prognosis, persistent primitive reflexes, absence of functional communication and significant cognitive delay.4 According to parameters established by the WHO, 96.1% of children with CP related to CZS present gross motor skills at 2 years of age that are normally found in an infant of up to 4 months. Motor development curves in this same group, according to the GMFCS, demonstrate that children with quadriplegia have already obtained approximately 90% of their expected development potential.20
Postural asymmetry in non-ambulant adults with cerebral palsy: a scoping review
Published in Disability and Rehabilitation, 2019
Carlee Holmes, Kim Brock, Prue Morgan
Not surprisingly, more recent studies used the GMFCS to describe their populations as Levels IV and/or V [2,4,10,11, 16–18,23–25] with generally older studies using terms such as “bed ridden”, “propped sitters”, or “non-ambulatory” to describe the motor function of participants [12,19–22,26,27]. In these instances, the review authors converted descriptions to equivalent GMFCS Levels. Four studies [4,16,23,24] exclusively recruited those at GMFCS Level V, with the remaining studies including both GMFCS Levels IV and V participants. Where reported, spastic quadriplegia was the dominant motor type and distribution. As expected, many participants had additional impairments such as epilepsy, intellectual impairment, and were non-verbal. All but one study [24] recruited exclusively those with a diagnosis of CP. Sato’s study [24] included two of 22 participants with other neurological disorders. Where reported (n = 14), the mean age was less than 40 years old in 11 studies. A further three of these 14 studies included participants with a mean age between 40 and 45 years [4,24,27]. Eleven studies included broader inclusion criterion of which relevant data pertaining to postural deformities, adult age groups and/or GMFCS Levels IV and V was extracted. Table 1 synthesises the study type and demographic information regarding included study participants.
Prognostic predictors for ambulation in children with cerebral palsy: a systematic review and meta-analysis of observational studies
Published in Disability and Rehabilitation, 2018
Orawan Keeratisiroj, Nuanlaor Thawinchai, Wantana Siritaratiwat, Montana Buntragulpoontawee, Chayanin Pratoomsoot
Finally, the absence of epilepsy or seizure represented a good predictor of ambulation in children with cerebral palsy. Seizures are abnormal electrical activity of the brain resulting in brain development problem which causes gross motor development failure.[43] The seven studies were combined and the same conclusion was reached: approximately 1–2-folds of the number of children without epilepsy or seizure were able to walk compared with the number of children with these symptoms.[16,18–20,22–24] There was a study by Simard-Tremblay et al. [18] which reported a higher RR because in this study, the specific participants were children with spastic quadriplegia. Quadriplegic children demonstrate more frequent onset of seizures than other types of cerebral palsy.[40]