Ataxic Cerebral Palsy.pptx

Neuroscience

1. ATAXIC CEREBRAL PALSY

2. INTRODUCTION Ataxic Cerebral palsy is primarily a disorder of balance and control in the timing of coordinated movements along with weakness, incoordination, a wide-based gait, and a noted tremor. Caused by damage to cerebellum.

3. incidence Ataxic CP is relatively rare form of cerebral palsy and may be part of a dysmorphic syndrome or be associated with intra-uterine infection. Occurs in only 10% of all CP cases.

4. Causes  Prematurity.  Asphyxia.  Head trauma during or after birth.  Severe neonatal jaundice.  Hypoglycemia.  Intra-uterine viral infection.  Neonatal meningitis.  Genetic causes.  Brain hemorrhaging from fetal stroke.

5. Clinical features  Hypotonia.  Imprecise motor skills.  Disturbance of balance.  Inco-ordination.  Intention tremor.  Dysarthria.  Nystagmus.  Ataxic gait.

6. diagnosis  Ataxic CP isn't diagnosed until the child begins to show developmental delays. (awkward movements, slow eye movements when following objects, difficulties in grasping objects)  Diagnosis depends on patients history and on the basis of significant delay in gross and fine motor function , with abnormalities in tone , posture and movement on neurological examination.  MRI & CT scans are also done to reveal treatable conditions.    APGAR scores  are sometimes used as one factor to predict whether or not an individual will develop CP.  Movement Assessment of Infants (MAI) is able to predict CP at 4 months (motor delays)   Bayley scale is able to predict CP at 1 year (developmental delays in gross & fine motor & cognitive domains)

7. assessment History  Prenatal history . Perinatal history . Postnatal history . On observation : Behaviour of child. Communication of child. Other observations like involuntary movements, deformities, trophic changes, gait and postural abnormalities. Higher cognitive function. Cranial nerve integrity & special senses.

8. assessment   On Examination :  Sensory assessment. Motor integrity. Reflex integrity. ROM & Flexibility. Anthropometric measurement. Developmental milestones. Joint ROM (Active & Passive) Posture, Balance & Gait. Bowel & Bladder involvement. Functional Capacity.

9. management  COUNSELLING OF PARENTS  MEDICAL MANAGEMENT Oral medications such as Baclofen, Diazepam, Botulinum Toxin are used to reduce spasticity, improve muscle coordination and for muscle relaxation. Analgesic drugs to reduce intense pain or muscle spasm. Anticonvulsants drug to relieve or stop seizures.  SURGICAL MANAGEMENT Orthopedic surgery to correct contractures and deformities. Selective dorsal rhizotomy can help with severe muscle stiffness in the legs to improve walking. Gastrostomy to improve feedings, correct gastroesophageal reflux disease.

10. management PHYSICAL THERAPY  can help the child's strength, flexibility, balance, gait, mobility, postural deformities, contractures & motor development. Orthotic devices such as braces, casting & splints are also used to support and improve walking. OCCUPATIONAL THERAPY  using alternative strategies and adaptive equipment it promotes the child's independent participation in ADLs at home, school & community. SPEECH AND LANGUAGE THERAPY  help improve the child's ability to speak clearly or to communicate using sign language. RECREATION THERAPY  can help improve child's motor skills, speech & emotional well-being.