Pediatric Physical Therapy

Cerebral Palsy MCQ

Define "Cerebral Palsy" (CP):

 Cerebral palsy is a disorder of movement and posture that appears during infancy or
early childhood.
 CP is caused by non-progressive damage to the developing brain before, during
or shortly after birth.
 CP is not a single disease but a name given to a wide variety of static neuromotor
impairment syndromes, occurring secondary to a lesion in the developing brain (< 3
year).
The key features of cerebral palsy include all of the following except:
a) Abnormal movement and posture
b) Onset in first 3 years of life
c) Non-progressive
d) Mental retardation X
 In cerebral palsy, the brain damage is permanent and cannot be cured but the consequences can
be minimized. √
 Although CP is non-progressive, secondary impairments do develop throughout the
lifespan due to the effects of the brain damage. √
 In Congenital CP, the insult to the developing brain occurs during gestation or the birth
process (85% of cases). √
 In Acquired CP, the insult to the developing brain occurs after birth of the child but during
the first 3 years of life (15% of cases). √
 Enumerate Risk Factors (Causes) of Cerebral palsy: Prenatal, Perinatal, Postnatal (see
book Table p21)

 In Developed countries, Prematurity & Low birth weights are the 2 most important risk
factors for CP. In other countries, Postnatal risk factors additionally play a major role. √
 The Risk of cerebral palsy increase with:
1. Prematurity. √
2. Low birth weight. √
3. Hypoxic ischemic encephalopathy. √
4. Full term birth. X
5. Severe neonatal jaundice. √
 What is the clinical classification (clinical types) of CP (i.e. according to Tone
abnormalities)?
- Spastic ---------------------→(lesion: Motor cortex - Pyramidal)
- Dyskinetic---------------------→(lesion: Basal ganglia - Extrapyramidal)
- Hypotonic / Ataxic---------------------→(lesion: Cerebellum)
- Mixed---------------------→(lesion: Diffuse)

 The most common type of CP is Spastic (70-80%). √

 Spastic CP is characterized by injury to the cortex (pyramidal tract), tone is hypertonic. √
 Spastic CP is anatomically (topographically) Classified into 3 types: Hemiplegia (20%),
Diplegia (50%), and Quadriplegia. √
 The most common form of spastic CP is Diplegia. √
 In Hemiplegia:
- Upper & lower extremities on one side of the body are involved, with the upper
extremity more affected than the lower. √
- Accounts for 20% of cases with Spastic CP. √
- Very few associated problems (e.g. seizures, learning and behavior problems). √
- Functional prognosis is good compared to other types of CP. √
- All hemiplegic children learn to walk by age of 3 years. √

 In Diplegia:
- The 4 extremities are involved but the lower are more affected than the upper
extremities.
- Gross motor involvement of the lower and fine motor involvement of the upper
extremities
- A history of prematurity and low birth-weight is common causes of this type.