Skip to Main Content

++

CONDITION/DISORDER SYNONYM

++

  • Cerebral palsy (CP)

++

ICD-9-CM CODES

++

  • 343 Infantile cerebral palsy

  • 343.0 Congenital diplegia

  • 343.1 Congenital hemiplegia

  • 343.2 Congenital quadriplegia

  • 343.3 Congenital monoplegia

  • 343.4 Infantile hemiplegia

  • 343.8 Other specified cerebral palsy

  • 343.9 Infantile cerebral palsy, unspecified

++

ICD-10-CM CODES

++

  • G80.0 Spastic quadriplegic cerebral palsy

  • G80.1 Spastic diplegic cerebral palsy

  • G80.2 Spastic hemiplegic cerebral palsy

  • G80.3 Athetoid cerebral palsy

  • G80.4 Ataxic cerebral palsy

  • G80.8 Other cerebral palsy

  • G80.9 Cerebral palsy, unspecified

++

PREFERRED PRACTICE PATTERN

++

  • 5C: Impaired Motor Function and Sensory Integrity Associated with Nonprogressive Disorders of the Central Nervous System-–Congenital Origin in Infancy or Childhood1

++

PATIENT PRESENTATION

A 3-month-old infant referred to outpatient physical therapy following discharge from neonatal intensive care unit with diagnosis of CP. Infant was born at 27-week gestational age with Apgars of five at 1 minute and seven at 5 minutes. Past medical history includes respiratory distress syndrome, seizure disorder, and gastroesophageal reflux. Upon examination, infant exhibits poor head control, fisted hands, and inability to achieve prone on elbows.

++

KEY FEATURES

++
Description
++

  • Nonprogressive damage to cerebral cortex (and other parts of the brain, such as cerebellum) that occurs during prenatal, perinatal, or postnatal period2

++
Essentials of Diagnosis
++

  • Four types of muscle tone (and percentage occurrence in children with CP)3

    • Hypotonia

    • Hypertonia (70%–75%)

    • Ataxia (10%–15%)

    • Athetosis (20%)

  • Distribution of muscle tone

    • Quadriplegia: All four limbs involved, arms more than legs; cervical area, oral area

    • Diplegia: Primarily legs involved4

    • Hemiplegia: Primarily ipsilateral arm and leg involved4

    • Monoplegia: Only one limb involved

    • Triplegia: Only three limbs involved

    • In athetosis and ataxia, most often total body distribution: No hemiplegia, diplegia

  • Gross motor function classification system5

    • Level I (least involved)

    • Level II

    • Level III

    • Level IV (most involved)

++
FIGURE 232-1

Schematic representation of surgical options for muscle release or lengthening in cerebral palsy. A: Myotomy; B: tenotomy; C: aponeurotomy. (From Skinner HB. Current Diagnosis & Treatment in Orthopedics. 4th ed. www.accessmedicine.com. Copyright © The McGraw-Hill Companies, Inc. All rights reserved.)

Graphic Jump Location
++
General Considerations
++

  • Muscle tone often presents as hypotonia but changes before 12 months of age, most often to hypertonia depending on the type of CP

  • Infants (under age 12 months) can also have “transient” muscle tone within first year of life; may initially present as hypertonic but resolves spontaneously without development of CP

  • Associated disorders

    • Seizure disorder (in 50% of CP cases)3

    • Cognitive impairment (in 53% of CP cases)

    • Orthopedic deformities

    • Sensory integration dysfunction

    • Speech and language deficits

    • Difficulty feeding

    • Microcephaly3

    • Respiratory distress

    • Bronchopulmonary dysplasia6

    • Hydrocephalus3

    • Retinopathy of prematurity7

    • Visual impairment

    • Auditory impairment

    • Gastroesophageal reflux8

++...

Want remote access to your institution's subscription?

Sign in to your MyAccess profile while you are actively authenticated on this site via your institution (you will be able to verify this by looking at the top right corner of the screen - if you see your institution's name, you are authenticated). Once logged in to your MyAccess profile, you will be able to access your institution's subscription for 90 days from any location. You must be logged in while authenticated at least once every 90 days to maintain this remote access.

Ok

About MyAccess

If your institution subscribes to this resource, and you don't have a MyAccess profile, please contact your library's reference desk for information on how to gain access to this resource from off-campus.

Subscription Options

AccessPhysiotherapy Full Site: One-Year Subscription

Connect to the full suite of AccessPhysiotherapy content and resources including interactive NPTE review, more than 500 videos, Anatomy & Physiology Revealed, 20+ leading textbooks, and more.

$595 USD
Buy Now

Pay Per View: Timed Access to all of AccessPhysiotherapy

24 Hour Subscription $34.95

Buy Now

48 Hour Subscription $54.95

Buy Now

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.