1. Cerebral Palsy H.Makhmalbaf MD Consultant Knee Surgeon

2. Cerebral palsy Description Prenatally,30% Perinatally,60% Postnatally,10%

3. Epidemiology 0.6-5.9 patients in 1000 live births Prenatal care Socioeconomic condition of parents Type of obstetric &pediatric care the mother & child receive In the USA 2/1000 live births NICU,low birth weight

4. Types of CP Spastic 65% injury to pyramidal tracts Athetosis is a type of dyskinesia,injury to extrapyramidal brain lesion –Dystonic Athetosis,choreiform –rigid athetosis Ataxic Mixed,both pyramidal & extra

5. Types of CP If the lesion is in the cortex Midbrain or base of the brain Cerebellum,ataxia Widespread brain involvement

6. studies Cerebral blood flow CT US MRI In the NICU’s

7. Prenatal causes Congenital brain defect Mother had rubella or viral infection Erythroblastosis fetalis Fetal anoxia Maternal cardiovascular disease Alcohol,diabetes mellitus,thyroid abnorm

8. Natal causes Trauma or asphyxia Trauma,internal cerebral hemorrhage In eclampsia Delay in delivery Fetal aspiration Anaesthetic complications Prematurity

9. Postnatal causes Encephalitis Meningitis Trauma,head injuries Vascular accidents Asphyxia Prevention –immunization,antibiotics

10. Clinical types Or geographic classification Monoplegia Hemiplegic Diplegia Quadriplegia

20. Diagnosis Newborn or childhood Developmental delay Tests Reflexes

21. Deformities Spine Shoulder Elbow Wrist Hip,knee,ankle

22. Treatment Physical independence Commiunication Mobility,activity of daily life Ambulation Surgical treatment

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