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The syndrome is caused by non-progressive brain damage occurring before birth or within 1 month after birth.
The damage is to the brain¡¯s motor control centers, inhibiting the development of movement and causes abnormal posture.
Diagnosis of cerebral palsy has several essential factors: Bodily movement shows obvious signs of impairment, dystonia, unusual posture and abnormal motion patterns, abnormal reflexes (unconditional reflex, sets up straight reflection, balanced reflection).
Primary high-risk factors for cerebral paralysis: suffocation, premature birth, nuclear jaundice, congenital heteroplasia.
Cerebral palsy complications: Mental handicap, barrier to cognitive development, epilepsy, sensory impairments.
Spastic type
Involuntary athletic type: athetoid , myodystony, fremitus
Ataxia type
Mixed type
Atonia type
Characteristics of the spastic type:
Upper limbs: increased muscle tension, shoulder joint adduction, elbow flexing, forearm pronation, bending of the finger joints and palm, thumb adduction
The lower limbs extensor tension is increased, hip adductor group, quadriceps femoris, triceps surae muscle tension is increased, hip joint flexure, adduction and involute, knee joint flexure, sharp foot, strephenopodia, strephexopodia
Seat: pelvis caster, round back when sitting with legs extended, ¡°W¡± sitting posture
Standing: sharp foot, walking with a scissors gait, hemiparalysis towing gait
Characteristics of involuntary athletic:
The muscular tone is unstable, increases when anxious, during the infant stage polymyarian tension is low, and the symptoms are obvious when the patient is two or three years old
Involuntary body movements, especially in the face, arms and torso, uncoordinated movements, loss of motion increases
A lack of continuous control over posture
Restricted movement in the oral-facial muscles affecting the tongue, the throat and swallowing capability, dyslalia, dysphonia, laryngeal stridor, disturbance of food intake, increased salivation
Movement range is large
A characteristic symptom is dehise yawning with effort
Unusual posture with low muscular tone:
1. Frog position posture
2. While in a sitting position, there is difficulty raising the head
3. Sitting with upper body anteversion
4. Inverted ¡°U" posture while the patient is bolstered up horizontally
5. Winged shoulder posture
Unusual posture with hypermyotonia:
1. Head dorsiflexion
2. Opisthotonos
3. Upper limbs: shoulder joint adduction and involute, forearm pronation and extended back, hand makes a fist, hand too far extended
4. Lower limbs: Rigid extension, scissors shaped, sharp foot (6 months later)
5. Kneeling warrior, sitting with legs extended straight
6. TLR (buttocks is higher while the head is low), ATNR posture (asymmetrical tonic neck reflex) Because of the high muscle tone of the neck, the posture mimics the pose of an archer
Methods to treating cerebral palsy:
Physical therapy, PT
Occupational therapy, OT
Speech therapy, ST
Education therapy
Pharmacotherapy: neurophic medication infusion , botulinus toxin A infusion
Chinese traditional treatment: Medicinal bath, wax therapy, massage, acupuncture
Surgical therapy-neural stem cells transplantation and surgery
The treatment principle with regards to cerebral palsy:
The convulsions (including infant hemiparalysis) mainly reduces muscular tone, promotes the infant¡¯s motor ability growth, and encourages the infant to become more active.
Movement principle of involuntary movement: stabilize, median line, flexure pattern, controlling the posture
During daily treatment the nurses should pay special attention to:
Training time
Helping to correct the posture while the patient is seated
Making sure there is plenty of opportunity to practice standing and walking
Focusing on oral cavity mastication, question movement difficulties as soon as possible
Raise the infant¡¯s level of intelligence
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