What is Cerebral Palsy ?
■ It is a common congenital condition, where
the child presents with musculoskeletal and
cognitive problems, caused by injury to the
immature brain.
What causes Cerebral palsy?
■ prematurity (most common)
■ anoxic injuries
■ prenatal intrauterine factors
■ perinatal infections
○ toxoplasmosis
○ rubella
○ cytomegalovirus infection
○ herpes simplex
○ ToRCH
■ meningitis
■ brain malformations
■ brain trauma – NAT
How is Cerebral Palsy diagnosed?
■ Clinically
○ evaluation of developmental milestones,
○ cognitive function, and
○ musculoskeletal abnormalities such as
■ spasticity,
■ loss of motor control, and
■ impaired balance.
How is Cerebral Palsy treated?
■ physical therapy
■ bracing/orthotics,
■ medications for spasticity
Role of Botulinum Toxin in management of
cerebral palsy?
■ competitive inhibitor of presynaptic
cholinergic receptors with a finite lifetime
(usually lasts 2-3 months)
■ used to maintain joint motion during rapid
growth when a child is too young for surgery
■ often injected into gastrocnemius
■ helpful treatment in dynamic contractures;
little benefit with static contractures
Surgical Management of Cerebral Palsy?
■ SEMLS surgery (Single-Event, Multi-Level
Surgery)
■ concept arose to limit multiple
surgeries, anesthetics, and rehabilitation
time for children
■ most successful when combined with a
thorough gait lab assessment that
predicts improvement in function with
multiple level surgical interventions
■ simple lengthenings can cause
deterioration in gait when other
contractures are “uncovered”; SEMLS
management seeks to avoid these
iatrogenic complications
■ can be done on bilateral lower
extremities in efforts to improve gait
For More Details
Contact
Dr Gaurav Jain
20 B Sainath Colony , Indore
Call us 9111464959
Visit our Website Ortho-Care
