Cerebral palsy and hypoxic-ischaemic encephalopathy

Cerebral Palsy is a group of permanent movement disorders that appear in early childhood, attributed to non-progressive disturbances that occurred in the developing foetal or infant brain.

• Caused by factors that affect brain development before, during, or shortly after birth.
• These include premature birth, maternal infections, genetic mutations, and birth complications like asphyxia.

1. Spastic CP: Characterised by stiffness and movement difficulties.
2. Dyskinetic CP: Involves uncontrolled movements.
3. Ataxic CP: Causes poor balance and coordination.
4. Mixed CP: A combination of the above types.

• Varying levels of muscle control, coordination, and tone.
• Delays in reaching motor milestones.
• Speech and swallowing difficulties.
• Intellectual disabilities in some cases.
• Seizures, vision and hearing problems.

• Based on developmental history and physical examination.
• Neuroimaging (MRI) to identify brain abnormalities.
• Multidisciplinary assessment for associated conditions.

• Multidisciplinary approach including physical therapy, occupational therapy, and speech therapy.
• Medications for spasticity and seizures.
• Orthopaedic interventions for musculoskeletal complications.
• Educational and social support.

• Cerebral palsy is a group of permanent movement disorders that appear in early childhood.
• Patients present with varying levels of muscle control, coordination, and tone.
• Diagnosis is primarily through history and examination.
• Physical, occupational and speech therapy are key components in management.
• Multidisciplinary approach, patient education and support is crucial.

HIE is a type of brain dysfunction that occurs when the brain gets insufficient oxygen or blood flow for a period of time.

• Hypoxia and ischemia lead to a cascade of events causing cell death and brain injury.
• This can result in cerebral oedema and further compromise cerebral blood flow.

• Commonly occurs around the time of birth due to birth asphyxia.
• Other causes include cardiac arrest, severe hypotension, and respiratory failure.

• Severity ranges from mild symptoms to severe impairment or death.
• Symptoms include poor muscle tone, weak reflexes, shallow breathing, and reduced consciousness.
• Severe cases can lead to seizures, coma, and multi-organ failure.

• Clinical assessment including Apgar scores, blood gases, and neurological examination.
• Neuroimaging (MRI or CT) for extent and pattern of brain injury.
• Continuous EEG monitoring in severe cases.

• Immediate resuscitation and stabilisation.
• Therapeutic hypothermia (cooling) is the standard treatment for neonates with moderate to severe HIE.
• Supportive care and monitoring for seizures and other complications.

• Varies based on severity and response to treatment.
• Can result in long-term neurological deficits, including cerebral palsy, cognitive impairments, and epilepsy.

• HIE occurs when the brain gets insufficient oxygen or blood flow for a period of time, often due to birth asphyxia.
• Prompt diagnosis and intervention is required to prevent long-term neurological deficits.
• Severity of presentation varies, from poor muscle tone and weak reflexes to seizures and multi-organ failure.
• Investigations involve clinical assessment and neuroimaging.
• Immediate resuscitation is required, along with therapeutic hypothermia (neonates), supportive care and continuous monitoring.