1. CEREBRAL PALSY (CP)
فلج مغزی

2. CEREBRAL PALSY Definition
Cerebral palsy is the result of a brain lesion
The brain lesion must be fixed and nonpr gressive.
The abnormality of the brain results in motor
impairment

3. Epidemiology
In recent reports the incidence has been estimated to be between 2.4 and 2.7 per 100O Live births. (low birth weight tiny neonates)
The risk for cerebral palsy in a child born full-term is approximately 1 in 2000.

4. Epidemiology
Cerebral palsy was diagnosed in 12.3% of infants born at between 24 and 33 weeks of gestation.
Approximately 50% of children with cerebral palsy have low birth weight, and 28% weight less than 1500 g at birth.

5. Epidemiology
The incidence of cerebral palsy in recent studies of multiple births is
9 to 12 per in twins
31 to 45 per in triplets
111 per 1000 in quadruplets.

6. Etiology
PRENATAL
The TORCHES group of infections (toxoplasmosis, rubella, cytomegalovirus, herpes, and syphilis)
Cocaine, heroin, and marijuana
Congenital malformations
Rhesus blood group incompatibility resulting in
kernicterus as a cause of cerebral palsy

7. Etiology
PRENATAL
Prenatal chorioamnionitis and maternal infection have been associated with an
increased risk for premature onset of labor and cerebral palsy in the infant.
placental abnormalities
Fetal biophysical profile scores are prenatal noninvasive tests used to monitor the health of the developing fetus.

8. Etiology PERINATAL Anoxia as a result of perinatal complications
(A tight nuchal Cord or placental abruption)
Premature delivery
Sepsis in the neonatal period
Extracorporeal membrane oxygenation (ECMO
Heart surgery before the age of 1 month resulted in cerebral palsy in 25% of infants.

9. Etiology
POSTNATAL
Infections such as meningitis in early childhood can lead to cerebral palsy
Cardiopulmonary arrest
Suffocation
Motor vehicle accidents
Severe falls, and child abuse

10. Classification PHYSIOLOGIC
The most common movement abnormality is Spasticity.
Hypotonia
Dystonia
Athetosis
Patients with cerebral palsy frequently have a mixed form of movement disorder

11. classification GEOGRAPHIC
what part of the body is affected by cerebral
palsy.
Hemiplegia
Diplegia
Triplegia
Quadriplegia
total body involvement,

13. PHYSICAL EXAMINATION Muscle Tone Reflexes
Deep tendon reflexes (hyperreflexia & clonus)
Infantile reflexes (3-6 mouth.)
- startle reflex, or Moro's reflex
- tonic neck reflex
- parachute reflex (5 month. Appears)

14. Physical examination
Balance, Sitting, and Gait
Gait Analysis
Cadence. (number of steps per minute),
Scissor gait
crouch gait
Knee flexion contracture and Genu recurvatum
equinus contractures.
toe-walking

16. Treatment NONSURGICAL TREATMENT Physical Therapy Casting
Orthoses (AFOs)
dynamic equinus, foot drop,

17. Treatment MEDICAL TREATMENT OF SPASTICITY Oral Medication
diazepam and baclofen
Intrathecal Baclofen
Botulinum Toxin(Botox)
Clostridium botulinum and works by blocking the release of acetylcholine at the neuromuscular junction.

18. Treatment Surgical treatment Tenotomies Adductor muscle tendon
Hamstring muscle tendon
Achill tendon
Tendon transfer
Osteotomies