cerebral palsy (CP) [L, cerebrum + Gk, para, beyond, lysis, loosening] , a motor function disorder caused by a permanent, nonprogressive brain defect or lesion present at birth or shortly thereafter. The disorder is usually associated with premature or abnormal birth and intrapartum asphyxia, causing damage to the nervous system. Also called congenital cerebral diplegia, Little’s disease. ▪ OBSERVATIONS: The neurological deficit may result in a wide variety of symptoms, including spastic hemiplegia, monoplegia, diplegia, or tetraplegia; athetosis or ataxia; seizures; paresthesia; varying degrees of intellectual impairment; and impaired speech, vision, and hearing. Difficulties with breathing, sucking, swallowing, and responsiveness are usually apparent soon after birth, but the characteristic stiff, awkward movements of the infant’s limbs may be missed for several months. Walking is usually delayed, and when it is attempted, the child manifests a typical scissors gait. The arms may be affected only slightly, but the fingers are often spastic. Deep-tendon reflexes are exaggerated, and there may be slurred speech, delay in development of sphincter control, and athetotic movements of the face and hands. ▪ INTERVENTIONS: Early identification of the disorder facilitates the development of a comprehensive plan for infants with cerebral palsy and the initiation of an individualized therapeutic program. Treatment is individualized and may include the use of orthotics, braces, and supports; surgical correction of deformities; physical, occupational, and speech therapy; and various indicated drugs, such as muscle relaxants, oral antispasticity and antidystonic medications, injectable botulinum toxin, and anticonvulsants. ▪ PATIENT CARE CONSIDERATIONS: Cerebral palsy includes a large group of childhood movement disorders. The pattern of symptoms and their severity vary widely, depending on the area of the central nervous system compromised. A multidisciplinary team approach is vital for all aspects of management to improve function and minimize disability.
