Cerebral PalsyMakrina Morozowski

Outline

Definition Causation Associated Problems Diagnostic Criteria Multidisciplinary Team Treatments

Baclofen Botox

What Is Cerebral Palsy (CP)?

Perinatal Males Not genetic Life long Is not communicable 2/1000

Causation

Asphyxia, lack of oxygen Trauma or injury Stroke

Low birth weight Prematurity Maternal infection during

pregnancy Blood incompatibility

Co-morbid Disorders/ Associated Problems

Intellectual capacity or mental impairment

Speech difficulties Epilepsy and seizures Growth problems

Diagnostic Criteria

Reaching milestones Primitive reflexes

Physiological classification

Geographical classification

Physiological Classification

Spastic Athetoid /Dyskinetic Ataxic Hypotonic

Mixed

Geographical Classification

Multi-Disciplinary Team

Pediatrician Orthopedic Doctor Neurologist Physiotherapist Occupational therapist Speech therapist Orthotist Social worker Psychologist

TREATMENTS

Baclofen

Botox

What Is Baclofen?

Muscle relaxant Action potential GABA B agonist Oral baclofen Intrathecal baclofen Side Effects

Baclofen In Action

Brochard, Remy-Neris, Fillipetti, and Bussel (2008).

Less supportive

Hoving et al., (2009).Control and pumpSpasticity

What Is Botulinum Toxin Type A (Botox)?

Neurotoxin Acetylcholine (ACH) Administered Common Effects

How Botox Works

Cell communication Botox SNARE complex

SNAP-25

Nerve impulses

Summary

Defined CP Causation Co-morbid Disorders Diagnostic Criteria Team of Professionals Assessment Tools Treatments

Questions

References

Agarwal, A., & Verma, I. (2012). Cerebral palsy in children: An overview. Journal of Clinical Orthopaedics and Trauma, 3, 77-81. doi: 10.1016/j.jcot.2012.09.001

Bandholm, T., Jensen, B, R., Neilsen, L, M., Rasmussen, H., Bencke, J., Curtic, D., … Sonne-Holm, S. (2012). Neurorehabilitation with versus without resistance training after botulinum toxin treatment in children with cerebral palsy: a randomized pilot study. NeuroRehabilitation, 30, 277-286. doi: 10.3233/NRE-2012-0756

Brochard, S., Remy-Neris, O., Filipetti, F., & Bussel, B. (2008). Intrathecal baclofen infusion for ambulant children with cerebral palsy. Pediatric Neurology, 40(4), 265-270. doi: 10.1016/j.peidatrneurol.2008.10.020

Haslaas, Y. (n.d.). Xeomin injections- Are you a candidate? [On-line]. Retrieved from http://www.facialplasticsurgery.net/xeomin-injections.htm

Hinchcliffe, A. (2007). Children with cerebral palsy. A manual for therapists, parents and community workers. (2nd.ed.). What is cerebral Palsy and how does it affect children? (pp.13-24). Thousans Oaks, California: Sage Publications Inc.

Hoon, A, H., & Tolley, F. (2013). Cerebral Palsy. In Batchaw, M, L., Roizen, N, J., & Lotrecchiano, G, R. (Eds.), Children with Disabilities (7 ed.). (pp. 423- 450). Baltimore, Maryland: Paul H. Brookes Publishing Co.

Hoving, M, A., Van Raak, E, P, M., Spincermaille, G, H, J, J., Palmans, L, J., Becher, J, G., & Vles, J, S, H. (2009). Efficacy of intrathecal baclofen therapy in children with intractable spastic cerebral palsy: a randomized controlled trial. European Journal of Peadiatric Neurology, 13, 240-246. doi: 10.1016/j.ejpn.2008.04.013

References

http://www.byhealth.com/cerebral-palsy-cp http://www.bcchildrens.ca/Services/SurgeryAndSurgSuites/OrthopaedicSurge

ry/Orthopaedic+Cerebral+Palsy+Clinic/cerebral+palsy.htm http://suppversity.blogspot.ca/2011/08/suppversity-emg-series-gluteaus-max

imus.html

http://www.rnoh.nhs.uk/clinical-services/rehabilitation-and-therapy/gait-analysis-laboratory

http://www.skincarebydesign.com/Reference/BotoxComparePage.shtmlhttp://multiple-sclerosis-research.blogspot.ca/2013/02/research-spasticity-neuros-need-to.html

http://www.fortmacleodgazette.com/2012/students-share-their-story-of-overcoming-challenges/

http://www.mushymamma.com/2011/11/remembering-my-twin-boys-during-prematurity-awareness-month/

http://www.cmpa-acpm.ca/cmpapd04/docs/ela/goodpracticesguide/pages/communication/Team_Communication/tools_and_techniques-e.html

http://www.interactivemetronome.com/IMW/IMProvider/eNews/Provider_E-News_FebMar_10.htm

References

MedAmin (Producer). (2009). Botox ® Mechanism of Action Video [You-Tube]. Available from http://www.youtube.com/watch?v=dkpohXE06pg

Molenaers, G., Schörkjuber, V., Fagard, K., Van Campenhout, A., De Cat, J., Pauwels, P., … Desloovere, K. (2009). Long-term use of botulinum toxin type A in children with cerebral palsy: treatment consistency. European Journal of Paediatric Neurology Society, 13, 421-429. doi: 10.1016/j.ejpn.2008.07.008

Miller, F., & Bachrach, S, J. (2006). Cerebral Palsy: A Complete Guide for Caregiving (2nd ed.). Balitmore: Johns Hopkins University Press.

Pincus, D. (2000). Everything you need to know about cerebral Palsy. New York, NY: The Rosen Publishing Group, Inc.

Tedroff, K., Granath, F., Forssberg., & Haglund-Akerlind, Y. (2009). Long-term effects of botulinum toxin A in children with cerebral palsy. Developmental Medicine & Child Neurology, 51, 120-127. doi: 10.1111/j.1469-8749.2008.03189.x

Zdolsek, H, A., Olesch, C., Antolovich, G., & Reddihough, D. (2011). Intrathecal baclofen therapy: benefits and complications. Journal of Intellectual & Developmental Disability, 36(3), 207-213. doi: 10.3109/13668250.2011.595707