Diagnosis and Management of Orthopedic Problems in Children with Cerebral Palsy

ABSTRACT

Cerebral palsy is a term applied to a variety of clinical syndromes that have as a common feature the abnormal control of motor function by the brain, resulting in disorders of movement and posturing. Sensory function is often affected as well. Cerebral palsy afflicts the immature brain (under 2 years of age) and usually produces neuropathologic changes that do not progress with increasing age. Because myelination of the brain is a progressive process that begins late in the third trimester and continues into adolescence in a well defined pattern, only after the neuronal pathways from brain lesions have become myelinated and the pattern of abnormality determined, can the brain lesions forming the basis of cerebral palsy be detected.

Cerebral palsy may result from a variety of insults to the brain, including prenatal causes such as maternal infection, drug or alcohol abuse, and severe toxemia, as well as perinatal hypoxia, postnatal head trauma, vascular accidents, central nervous system infections, or hypoxia form a variety of causes.^1,2 Only about 10 to 15% of cases of cerebral palsy will result from perinatal hypoxia or other problems.¹

Cerebral palsy occurs in 1 to 7 of every 1000 children worldwide and is approximately 12 times more common in a child of a twin pregnancy, mostly related to low birth weight.¹

KEYWORDS

Cerebral palsy - musculoskeletal system - orthopedics - imaging - pediatrics