Cerebral Palsy is a group of disabilities caused by injury or insult to the brain either before or during birth, or in early infancy. Cerebral refers to the cerebrum, which is the affected area of the brain (although the disorder most likely involves connections between the cortex and other parts of the brain such as the cerebellum, and palsy refers to disorder of movement. CP is caused by damage to the motor control centers of the developing brain and can occur during pregnancy (about 75 percent), during childbirth (about 5 percent) or after birth (about 15 percent) up to about age three.It is a non-progressive disorder, meaning the brain damage does not worsen, but secondary orthopedic difficulties are common.
Clinical hallmarks include hypertonicity with poor control of posture, balance, and coordinated movement, and impairment of fine and gross motor skills. Major manifestations are athetosis (wormlike movement), dyskinetic movement of mouth, drooling and dysarthria. Movements may become choreoid (irregular, jerky) and dystonic (disordered muscle tone), especially when stressed and during the adolescent years. Other prenatal or perinatal risk factors include: asphyxia, ischemia, perinatal trauma, congenital and perinatal infections, and perinatal metabolic problems such as hyperbilirubinemia and hypoglycemia.
Disabilities usually result from injury to the cerebellum, the basal ganglia or the motor cortex.
It is difficult to establish the precise location of neurologic lesions because there is no typical pathologic picture.
Disabilities associated with Cerebral Palsy include mental retardation, seizures, attention deficit disorder and sensory impairment. Severe cases may be observed at birth, mild and moderate cases usually are not detected until the child is 1 to 2 years old.
Other disorders, such as metabolic disorders, degenerative disorders and early slow-growing brain tumors are ruled out.
Prevent physical injury by providing the child with a safe environment, appropriate toys, and protective gear (helmet, kneepads) if needed.


Prevent physical deformity by ensuring correct use of prescribed braces and other devices and by performing ROM exercises. Promote mobility by encouraging the child to perform age-and condition-appropriate motor activities. Administer prescribed medications which may include sedatives, muscle relaxants and anticonvulsants.
Encourage self-care by urging the child to participate in activities of daily living (ADLs) (e.g. As necessary, seek referrals for corrective lenses and hearing devices to decrease sensory deprivation related to vision and hearing losses. Encourage family members to express anxieties, frustrations and concerns and to explore support networks. Prepare the child and family for procedures, treatments, appliances and surgeries if needed. Assist in multidisciplinary therapeutic measures designed to establish locomotion, communication and self-help, gain optimal appearance and integration of motor functions; correct associated defects as effectively as possible and provide educational opportunities based on the individual’s needs and capabilities. Braces to help prevent or reduce deformities, increase energy of gait, and control alignment. Orthopedic surgery to correct deformities and decrease spasticity (medications are not helpful for spasticity). Inform parents but their child will need considerable help and patience in accomplishing each new task.
Encourage the family to seek appropriate functional, adaptive and vocational training for the child. Encourage family members to achieve balance in their lives between caring for their disabled child and other family and personal matters.


Type 2 diabetes mellitus is characterized differently and is due to insulin resistance or reduced insulin sensitivity, combined with relatively reduced insulin secretion which in some cases becomes absolute. When glucose levels become depleted, glucagon and cortisol levels rise significantly to enhance gluconeogenesis. Up-regulation (receptors) occurs with insulin after 4 weeks of exercise to increase its sensitivity (diabetic importance).
This material is based upon work supported by the Nursing, Allied Health and Other Health-related Educational Grant Program, a grant program funded with proceeds of the State’s Tobacco Lawsuit Settlement and administered by the Texas Higher Education Coordinating Board. For example, onset of arthritis and osteoporosis can occur much sooner in adults with cerebral palsy. Medical intervention is limited to the treatment and prevention of complications arising from CP’s effects. Spastic Cerebral Palsy – is the most common type and may involve one or both sides of the body. Active attempts at motion increase the abnormal postures and lead to overflow of movement to other parts of the body. Ataxic Cerebral Palsy – is manifested by a wide-based gait, rapid repetitive movements performed poorly, and disintegration of movements of the upper extremities when the child reaches for objects. In some cases, the brain has gross malformations; in others, vascular occlusion, atrophy, loss of neurons and degeneration may be evident.



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