Skip to Main Content

++

Condition/Disorder Synonyms

++

  • CP

++

ICD-9-CM Code

++

  • 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 Code

++

  • 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 Pattern1

++
++

Key Features

++

Description

++

  • Non-progressive damage to cerebral cortex (and other parts of the brain, such as cerebellum) that occurs during prenatal, perinatal, or post-natal period

++

Essentials of Diagnosis

++

  • 4 types of muscle tone (and percentage occurrence in children with cerebral palsy)

    • Hypotonia

    • Hypertonia (70 to 75%)

    • Ataxia (10 to 15%)

    • Athetosis (20%)

  • Distribution of muscle tone

    • Quadriplegia: all 4 limbs involved, arms more than legs; cervical area, oral area

    • Diplegia: primarily legs involved

    • Hemiplegia: primarily ipsilateral arm and leg involved

    • Monoplegia: only one limb involved

    • Triplegia: only 3 limbs involved

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

  • Gross motor function classification system

    • Level I (least involved)

    • Level II

    • Level III

    • Level IV (most involved)

++

General Considerations

++

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

  • 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 cerebral palsy

  • Associated disorders

    • Seizure disorder (in 50% of cerebral palsy cases)

    • Cognitive impairment (in 53% of cerebral palsy cases)

    • Orthopedic deformities

    • Sensory integration dysfunction

    • Speech and language deficits

    • Difficulty feeding

    • Microcephaly

    • Respiratory distress

    • Bronchopulmonary dysplasia

    • Hydrocephalus

    • Retinopathy of prematurity

    • Visual impairment

    • Auditory impairment

    • Gastroesophageal reflux

++

Demographics

++

  • Present in 0.2% of the population

++

Clinical Findings

++

Signs and Symptoms

++

  • Delays in

    • Gross motor skills

    • Fine motor skills

    • Oral motor skills

    • Perceptual motor skills

    • Social-emotional skills

    • Speech and language skills

  • Abnormal muscle tone (decreased, increased, fluctuating)

  • Arching neck or back into extension

  • Scissoring legs (hip adduction) when held in standing

  • Describe classic rotary, writhing characteristic of movement in athetosis

  • Ataxia: hypotonia and tremulousness, unsteadiness in gait

++

Functional Implications

++

  • Abnormal movement postures

    • Capital hyperextension

    • Scapular retraction

    • Fisted hands

    • In supported standing

      • Hip adduction (scissoring)

      • Excessive knee flexion (“crouching”)

      • Plantarflexion (standing on toes)

      • Pronation (eversion)

  • Refusal to bear weight on feet or hands

  • Inability to move against gravity in prone ...

Pop-up div Successfully Displayed

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