Cerebral Palsy - (DETAILED) Overview

hello in this video we're going to talk about cerebral py cerebral pertaining to the brain and py as in paralysis now cerebral py is an umbrella term that refers to a group of disorders affecting a person's ability to move it is due to damage to the developing brain either during the pregnancy or shortly just after birth there's three important parts of the brain uh which is important to know when dealing with cereal py and these three areas are the cortex which is essentially the brain itself the basil ganglia within the brain and then the cerebellum cerebral py is a problem in one or more of these areas causing abnormal muscle tone posture and movement the clinical presentation again cerebral pulsy is a disorder that manifests shortly after birth early signs of cere py include do itility and irritability poor feeding abnormal reflexes abnormal muscle tone asymmetrical movement patterns but of course these signs can be missed and thought of as normal until the baby has grown and that is why it is important to monitor for delays in motor Milestones it is also important to know of the misconception that cerebral py gets worse as we age when actually cerebral py is a static disorder and is nonprogressive signs of cerebral py in childhood or cerebral py in general can be classified into three syndrome dis kinetic syndrome or axic syndrome not a kinetic a kinetic means no movement what's interesting is that these syndromes correlate to the brain areas we talked about at the beginning of the video the cerebrum or cortex the baso ganglia and the cerebellum now for syndrome this includes signs and symptoms such as tremas hypertonicity scissor gate and limb weakness the dis kinetic syndrome include abnormally slow movement writhing movement and this movement is exacerbated during stress or when there's no sleep the axic syndrome involves the cerebellum and so problems here causes a wide based gate and also intentional Tremor cerebral py is not only about movement and Motor problems there are lot of other complications associated with it and these include pain intellectual disability speech and language disorders epilepsy seizures visual impairment bladder problems Sleep Disorders hearing impairment hip displacement and also behavioral problems the diagnosis of cerebral py is clinical however an MRI of the brain can be performed if the cause of the signs and symptoms is unknown the management of cerebral py involves a multidisiplinary team because there are a lot of complications as we talked about the team involves a physiotherapy to help reduce impairment and optimize function occupational therapist for self-care skills and to increase Independence a speech therapist is here to to to assess for dysphasia and also to improve uh communication Orthopedic Specialists is important to help with uh with the motor problems with scoliosis of the spine which is common and to help with the use of various braces to help with movement a neurologist as well as a psychologist is important for mental health The General practitioner or family physician is probably the person who coordinates the whole thing then there's also the pediatrician and neurologist as well as a pediatric nurse if and when necessary let's talk about the mechanism of disease so it's important to recap a little bit about neurology or neuroanatomy so zooming into the brain here here we have the cerebrum the big matter of the brain it connects to the brain stem which then connects with the spinal cord the cerebellum is an important structure that sits below the brain or cerebrum at the back let's now cut a cross-section of the brain and we are looking at it from the front so straight at it in this brain section we are looking at the motor cortex the area of the cerebrum which helps initiate movement specifically voluntary movement so here is the right motor cortex and here is the left motor cortex neurons which arise from the right will travel down the spinal cord and send motor information to the left side of the body similarly neurons arising from the left motor cortex will go down and cross over supplying the right side of the body let us now zoom into the left motor cortex here is the left motor cortex and we can also see the left cerebellum at the bottom here now the motor cortex has a designated areas of of our body so for example this area correlates with the lower limbs this area the upper Limbs and here the facial area so if a neuron um is arising from the Upper Limb area here on the left motor cortex which is the area of the hand it means that the neuron will supply motor to the hand on the right side because remember it's supplying the opposite side of the body this area is called the cortex the brain cortex more specifically the motor cortex of course and it's also part of the parameter group it's part of the parameter group because uh neurons that are involved here are voluntary it's under conscious control here we have the basil ganglia and cerebellum which actually communicates with the voluntary neurons to help send coordinated learned movement patterns the basil ganglia and cerebellum is your extra paramal because they are not under conscious control the types of cereal py can be separated as we mentioned into areas affecting one or more of these regions so for example problems in in the cortex causes cerebral py problems in the basil ganglia causes dis kinetic cerebral py cerebella problems causes a toxic cerebral py and there's also mixed cerebral py which is a mixture of one or more cereal py causes stiffness with difficulty um moving the limbs copy is the most common type this kinetic serial py affects the basil ganglia producing involuntary and uncontrolled movement patterns which makes sense if you think about Parkinson's disease which also affects the basil ganglia a taxic cereal py affects the cerebellum and causes disturbance in the sense of balance and this is why patients who have axic cereal py have a wide gate then finally there is the mixed cerebral py while the cortex is part of the paramal group The basil ganglia and cerebellum as I mentioned is not part of conscious control and so it is the extra parameter group parameter Cal py involves voluntary motor neurons extra paramal cereal py involves involuntary motor neurons now problems in the cerebral cortex causes is cerebral py and it is part of the paramal voluntary group whereas extra paramal Cy affects the cerebellum and or basil ganglia and it's called a taxic or distic or athid cereal py let us focus on cerebral py first which affects the cerebral cortex now cerebral py is not only categorized as to the area of the brain affected but also how much of the body um is affected so for example here the effected regions of the motor cortex is the left Upper Limb and the lower limb regions which means that the right Upper Limb and the right lower limb are affected therefore this person will have stiff limbs on the right side and there's also increased tone here as well because half of the body on one side is affected this is called hemia similarly in this example the affected area is bilaterally the lower limbs of the motor cortex which means that the lower limbs of the person will be stiff and also have increased tone when the muscles in the lower limb are stiff increased tone different muscles work more than others and characteristic feature of copy is the scissor gate because the lower half of the body is affected this is also called paraplegia or diplegia other parts of the limbs can also be partially affected in cerebral py finally there's quadriplegia this is bilateral upper and lower limb motor cortex involvement there is also sissor stance with all limbs stiff so that was pyramidal cerebral py also known as cerebral py which affects the cerebral cortex now let's focus on the extra paramal cerebral py and here all the body is affected there is no hemiplegia there's no dlea there's no quadriplegia everything is affected Ed in a taxic cereal py the cerebellum is the problem the cerebellum is a very important structure in the brain for balance and coordination and so if this is affected there is balance and coordination difficulty as a result the person will have a wide gate in this kinetic cerebral py the basil ganglia is involved creating uncontrolled movements and and dystonia so what causes cereal py well there's no exact cause but there is thoughts that a number of things can or could have a relationship to cereal py and these include perinatal hypoxic esic injury prematurity which is seen in the majority of cerebral py patients antium Hemorrhage during pregnancy and intra utrine infections as well intra cranial Hemorrhage in the fetus or fetal stroke a risk is if a mother has multiple pregnancies and there's also possibly genetic susceptibility it's interesting to note that the majority 80% of cerebral py are due to perinatal or anti-natal factors and only uh less than 20 are actually quied after the neonatal period so that was for me but check out a great video on cerebral py by the osmosis team they go into a bit more detail on the pathophysiology behind cerebral py as well as the causes

Channel: Armando Hasudungan

Views: 847,498

Keywords: Neurology, pediatrics, paediatrics, Spastic cerebral palsy, different types of cerebral palsy, Signs and symptoms of cerebral palsy, cerebral palsy pathophysiology, pathogenesis, causes of cerebral palsy, neuroanatomy, medicine, diseases of the nervous system, muscle weakness, nervous system diseases, management of cerebral palsy, treatment of cerebral palsy, ataxic, complications of cerebral palsy

Id: 7fUGWKM32hE

Length: 13min 18sec (798 seconds)

Published: Tue Nov 21 2017