Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content ++ CP ++ 343 Infantile cerebral palsy343.0 Congenital diplegia 343.1 Congenital hemiplegia 343.2 Congenital quadriplegia343.3 Congenital monoplegia 343.4 Infantile hemiplegia 343.8 Other specified cerebral palsy 343.9 Infantile cerebral palsy, unspecified ++ G80.0 Spastic quadriplegic cerebral palsyG80.1 Spastic diplegic cerebral palsyG80.2 Spastic hemiplegic cerebral palsyG80.3 Athetoid cerebral palsyG80.4 Ataxic cerebral palsyG80.8 Other cerebral palsyG80.9 Cerebral palsy, unspecified ++ 5C: Impaired Motor Function and Sensory Integrity Associated with Nonprogressive Disorders of the Central Nervous System – Congenital Origin in Infancy or Childhood +++ 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)HypotoniaHypertonia (70 to 75%)Ataxia (10 to 15%)Athetosis (20%)Distribution of muscle toneQuadriplegia: all 4 limbs involved, arms more than legs; cervical area, oral areaDiplegia: primarily legs involvedHemiplegia: primarily ipsilateral arm and leg involvedMonoplegia: only one limb involvedTriplegia: only 3 limbs involvedIn athetosis and ataxia, most often total body distribution: no hemiplegia, diplegiaGross motor function classification systemLevel I (least involved)Level IILevel IIILevel 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 palsyInfants (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 palsyAssociated disordersSeizure disorder (in 50% of cerebral palsy cases)Cognitive impairment (in 53% of cerebral palsy cases)Orthopedic deformitiesSensory integration dysfunctionSpeech and language deficitsDifficulty feedingMicrocephalyRespiratory distressBronchopulmonary dysplasiaHydrocephalusRetinopathy of prematurityVisual impairmentAuditory impairmentGastroesophageal reflux +++ Demographics ++ Present in 0.2% of the population +++ Signs and Symptoms ++ Delays inGross motor skillsFine motor skillsOral motor skillsPerceptual motor skillsSocial-emotional skillsSpeech and language skillsAbnormal muscle tone (decreased, increased, fluctuating)Arching neck or back into extensionScissoring legs (hip adduction) when held in standingDescribe classic rotary, writhing characteristic of movement in athetosisAtaxia: hypotonia and tremulousness, unsteadiness in gait +++ Functional Implications ++ Abnormal movement posturesCapital hyperextensionScapular retractionFisted handsIn supported standingHip adduction (scissoring)Excessive knee flexion (“crouching”)Plantarflexion (standing on toes)Pronation (eversion)Refusal to bear weight on feet or handsInability to move against gravity in prone positionPoor head/trunk controlInability to sit independentlyInability to commando crawl or creep on hands and kneesInability to transition from one position to another, such as ... Your MyAccess profile is currently affiliated with '[InstitutionA]' and is in the process of switching affiliations to '[InstitutionB]'. Please click ‘Continue’ to continue the affiliation switch, otherwise click ‘Cancel’ to cancel signing in. Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Username Error: Please enter User Name Password Error: Please enter Password Forgot Username? Forgot Password? Sign in via OpenAthens Sign in via Shibboleth