CASE REPORT 0The present case is presented to show the effect of physical therapy on severely affected child using GMFCS as measurement scale pre- and post-therapy. The patient was a 9-year-old boy with spastic diplegia functioning at GMFCS Level V. [ijcpjournal.org]

In the past three years he has made presentations on the application of HBOT to autism and chronic neurological conditions to the U.S. [hbot.com]

The clinical presentation is variable. The most severe presentation is of infantile acidosis, resulting in death by 6 months of age. [adc.bmj.com]

[…] been associated with genetic abnormalities; congenital brain malformations; maternal infections or fevers; and/or injury before, during or shortly after birth. [1] [3] [4] There is no cure, and treatment options vary depending on the signs and symptoms present [rarediseases.info.nih.gov]

Certain medical conditions and factors may increase the risk of a child having cerebral palsy and spastic diplegia: Maternal infection or high fever during pregnancy; Complicated labor and delivery; Breech presentation; Rh (blood type) incompatibility [birthinjurysafety.org]

• Stridor

  Inspiratory stridor is a relatively common and additional characteristic feature and may occur at any stage of the disease. The nystagmus tends to resolve in later childhood. [adc.bmj.com]

• Failure to Thrive

  The initial presentation is commonly in the first year of life, with failure to thrive and hepatosplenomegaly. [adc.bmj.com]

  […] to Thrive Respiratory Problems Incontinence Intellectual Impairment This image gives a nice pictorial overview of the problems experienced by children with Cerebral Palsy. [physio-pedia.com]

• Muscle Spasticity

  Physical therapy helps to make their muscles flexible and increase the range of movement or motions. Botulinum toxin medication helps to reduce the spasticity from muscle. [trishlafoundation.com]

  The motor disorder may range from difficulties with fine motor control to severe spasticity (see MUSCLE SPASTICITY) in all limbs. [fpnotebook.com]

  […] find out the effectiveness of Myofascial Release on calf muscle, hamstring muscle and adductor muscles of hip spasticity in spastic diplegic subjects. [omicsonline.org]

  When assessing spasticity, a clinician will assess Which muscles are affected by spasticity Severity of the spasticity in each of the affected muscles How a person is able to control their muscles (can they activate individual muscles, can they voluntarily [cerebralpalsy.org.au]

  The child may have muscle weakness, poor motor control, or have shaking, also called spasticity, of the arms or legs. Muscle stiffness in the form of stiff legs or clenched fists may also be seen. [stanfordchildrens.org]

• Scissoring Gait

  Other signs and symptoms may include delayed motor or movement milestones (i.e. rolling over, sitting, standing); walking on toes; and a "scissored" gait (style of walking). [1] [2] As with other types of cerebral palsy, spastic diplegia is usually caused [rarediseases.info.nih.gov]

  People with spastic diplegia often walk with a “scissor gait” caused by tight muscles in the hips and legs. The muscles become so tight the legs want to turn inward and sometimes cross over each other at the knees. [cerebral-palsy-information.com]

  There are a host of ways that specialists use to correct the “scissor gait” of patients diagnosed with Spastic Diplegia. [medicalook.com]

  This causes a scissors gait, in which the hips are flexed, the knees nearly touch, the feet are flexed, and the ankles turn out from the leg, causing toe-walking. Learning disabilities and seizures are less common than in spastic hemiplegia. [healthcommunities.com]

  They may walk on their toes, or walk with a scissored gait. Fortunately, although symptoms may change as the child grows older, spastic diplegia does not worsen over time. [birthinjurysafety.org]

• Chest Deformity

  His body was completely stiff with marked asymmetrical spasticity in lower limbs, truncal dystonia, and chest deformity with cardio respiratory complications. [ijcpjournal.org]

• Acute Low Back Pain

  Wilson E, Donegam – Shoafl, et al., [2003]-Conducted a study on effects of MET in patients with acute low back pain. The results showed that MET was effective in decreasing disability and improving function in patients with acute low back pain. [ukessays.com]

• Clonus

  Ankle clonus. Bilateral Babinski sign. Scissoring posture of legs when held in the air supported by the axillae due to spasticity in the hip adductor muscles. Tiptoe walking. Atrophy and impaired growth of legs in severe cases. [pathophys.org]

  However, children aged 2 years and over with evolving CP will also have clonus and exaggerated deep tendon reflexes (DTRs) in the lower limbs. [adc.bmj.com]

  Further evidence of brain movement involvement on the hemiplegic side includes hyperreflexia of the deep tendon reflexes, ankle clonus, and extensor toe signs. [childneurologyfoundation.org]

  Clonus and muscle spasms are not uncommon. Clonus is a series of involuntary rhythmic muscular contractions and relaxations. These are caused by the pain and/or stress of muscle tightness, indicating especially hard-working and/or exhausted muscles. [abclawcenters.com]

  During testing we observed clonus only in gastrocnemius and soleus muscles. [omicsonline.org]

• Hyperreflexia

  Classification Physiologic Classification Spastic (most common) Velocity-dependent increased muscle tone and hyperreflexia with slow, restricted movement due to simultaneous contraction of agonist and antagonist muscles. [orthobullets.com]

  It is part of the upper motor neuron syndrome characterized by hyperreflexia, clonus, extensor plantar responses and primitive reflexes. Spastic Cerebral Palsy is the most common form of Cerebral Palsy. [physio-pedia.com]

  Hyperreflexia – Abnormal increase in deep tendon reflexes. Deep tendon reflexes are elicited by the striking of the muscle tendon with a reflex hammer. Hypertonia – Increased muscle tone from expected (See muscle tone). [childneurologyfoundation.org]

• Abnormal Gait

  Common patterns can be seen in people with Cerebral Palsy and movement-limiting symptoms can include: Contractures, or joints will not extend fully Movements can be exaggerated Abnormal reflexes Abnormal gait Crossed knees Walking on tiptoes Quick links [cerebralpalsy.org.uk]

  The abnormal gait is often quite bizarre and may initially be interpreted as psychogenic in origin or “hysterical”. The gait disturbance usually shows a dramatic and sustained response to small doses of levodopa. [adc.bmj.com]

• Bilateral Ankle Clonus

  As expected, neurologic examination discloses brain control involvement that is demonstrable in the legs (e.g., hyperactive deep tendon reflexes, bilateral ankle clonus, extensor toe signs)[see above]. [childneurologyfoundation.org]

Options for Cerebral Palsy Treatment Spastic diplegia cerebral palsy does not have any complete cure but the management in the condition of spastic CP is possible after some common treatments in patients. [trishlafoundation.com]

Experienced treatment teams for individuals with spastic diplegia CP can help determine the treatments which are best suited for them. [cerebralpalsylawdoctor.com]

[…] et al, NDT was compared to the Adeli Suit Treatment (AST) in twenty-four children with CP for four weeks, five days per week for two-hour sessions. [pediastaff.com]

Two approaches used for the treatment of children with physical disabilities are advanced physiotherapy treatment called Neuro developmental therapy (NDT) and muscle energy technique (MET). [ukessays.com]

United Cerebral Palsy Research & Educational foundation; The Adeli Suit [research fact sheet: diagnosis and treatment]. [cogprints.org]

With early intervention and proper treatment, the prognosis for children with spastic diplegia is favorable. [cerebralpalsyguidance.com]

Diplegic Cerebral Palsy Prognosis Per the U.S. National Library of Medicine (NCBI), prognosis is favorable for children with diplegic CP. As previously mentioned, diplegic CP is the least invasive type of CP, affecting mainly the legs. [birthinjuryguide.org]

Homeopathy Prognosis These children should be diagnosed early and treated as babies on neurological lines. The result of early treatment can be surprising. [icddelhi.org]

Prognosis CP is not a progressive but the symptomscan become more severe over time Prognosis depends on intensity oftherapy during early childhood Tend to develop arthritis at a youngerage than normal because of pressureplaced on joints by excessively [slideshare.net]

Prognosis Clin Obstet Gynecol. 2008 Dec;51(4):816-28. JAMA. 2002 Sep 18;288(11):1357-63. Pediatrics. 2011 Aug;128(2):e299-307. Dev Med Child Neurol. 2008 Jul;50(7):487-93. [pathophys.org]

Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. [icd10coded.com]

Etiology Clin Obstet Gynecol. 2008 Dec;51(4):775-86. Pediatr Neurol. 2009 Mar;40(3):168-74. [pathophys.org]

Traditionally prenatal etiology, prematurity, total growth retardation, perinatal asphyxia and other perinatal causes like trauma have all been implicated as risk factors for cerebral palsy. (National collaborative perinatal project NCPP data). [ukessays.com]

Several other classification systems exist based on the pathophysiology, etiology, and distribution of motor deficits [ 5 ]. [omicsonline.org]

Cerebral palsy epidemiology: where are we now and where are we going?. Dev Med Child Neurol. 1992 Jun. 34(6):547-51. [Medline]. Bax M, Goldstein M, Rosenbaum P, Leviton A, Paneth N, Dan B, et al. [emedicine.staging.medscape.com]

Cerebral palsy: classification and epidemiology. Physical Medicine and Rehabilitation Clinics of North America, 20(3), 425-452. doi: 10.1016/j.pmr.2009.06.001 See abstract Paneth, N. (2008). Establishing the diagnosis of cerebral palsy. [cerebralpalsy.org.au]

The epidemiology of cerebral palsy: incidence, impairments and risk factors. Disabil Rehabil. 28(4): 183-91. Review. Pandyan AD, Gregoric M, et al. 2005. Spasticity: clinical perceptions, neurological realities and meaningful measurement. [theratogs.com]

Epidemiology Unfortunately, it is difficult to access and clarify the prevalence and incidence rate of disabilities in poor-resource settings (Gladstone, 2010). [physio-pedia.com]

Epidemiology The incidence of CP is about 2 per 1000 livebirths The incidence is higher in males than infemales Other associated problems include◦ Mental disadvantage (IQ < 50): 31%◦ Active seizures: 21%◦ Mental disadvantage (IQ < 50) and not walking [slideshare.net]

Pathophysiology Arch Dis Child Fetal Neonatal Ed. 2008 Mar;93(2):F153-61. [pathophys.org]

Neonatal Encephalopathy and Cerebral Palsy: Defining the Pathogenesis and Pathophysiology. Washington, DC: American College of Obstetricians and Gynecologists; 2003. [Full Text]. Capute AJ, Accardo PJ, eds. [emedicine.staging.medscape.com]

Several other classification systems exist based on the pathophysiology, etiology, and distribution of motor deficits [ 5 ]. [omicsonline.org]

The CP prevention research was unveiled at the prestigious American Academy of Cerebral Palsy and Developmental Medicine Conference held in Orlando, Florida. [cpaustralia.com.au]

Minimizing the numbers of surgeries a child experiences is essential because it might prevent them from seeing themselves as being, 'sick.' [disabled-world.com]

Can cerebral palsy be prevented? In many cases, the cause of cerebral palsy is not known, so there is nothing that can be done to prevent it. [americanpregnancy.org]

The increased extensor spasm prevents the child from rolling over and the absence of body-righting reflexes prevents him from developing a reciprocal flexion and extension of the hips and knees to rollover smoothly. [icddelhi.org]

and joint receptors. [11] Severe consequences in a cerebral palsy child can be prevented with early diagnosis and comprehensive physiotherapy intervention. [ijcpjournal.org]