Cerebral Palsy

Presentation (signs and symptoms)

All types of cerebral palsy are characterized by abnormal muscle tone, posture, reflexes, or motor development and coordination. The classical symptoms are spasticity, unsteady gait, and dysarthria. CP symptomatology is as diverse as the individuals who have it. Secondary symptoms can include speech or communication disorders, seizures, hearing or vision impairment, cognitive disabilities, learning disabilities, and/or behavioral disorders. Soft tissue findings consist largely of decreased muscle mass.

Bones

In order for bones to attain their normal shape and size, they require the stresses from normal musculature. The osseous findings will therefore mirror the specific muscular deficits in a given patient. The shafts of the bones are often thin (gracile). When compared to these thin shafts (diaphyses) the metaphyses often appear quite enlarged (ballooning). With lack of use, articular cartilage may atrophy, leading to narrowed joint spaces.

Depending on the degree of spasticity in a given patient, they may exhibit a variety of angular deformities about their joints. Vertebral bodies also need vertical gravitational loading forces to develop properly. If a patient with cerebral palsy spends a great deal of time horizontal (in bed) during skeletal maturation, their adults vertebral bodies may be somewhat vertically elongated. Since the horizontal spines of quadrupeds normally appear this way, this finding in humans is sometimes referred to as "caninization". It is suggested to make the patient accustomed to sitting during skeletal maturation (childhood)because it is the easiest way of feeding and also the patient will not have difficulty with sleeping.