 Hi and welcome to Nursing School Explained. Today, we'll take a closer look at cerebral palsy. So cerebral palsy is a chronic and non-progressive neuromuscular disorder. Keep in mind, whenever there's something going on with the muscles, there's usually nerve involvement as well because without the nerve impulse, the muscles won't be receiving the signal to actually contract and relax. So cerebral palsy leads to difficulty controlling the muscles and there might also be possible comorbidities that affect the patient cognitively as well as their hearing, speech, and vision. And then they might also have seizures. So what causes cerebral palsy? There's been many discussions as to the causes but there seem to be related factors that there's some damage that occurs to the brain whether that's prenatally, during the birthing process or in the postpartum period. So low birth weight infants are at higher risk for developing cerebral palsy as well as multiple gestation infants. So twins, triplets, quadruplets are usually at a higher incident for being premature and that is also, multiple gestation is also related to infertility treatment. So there seems to be a relationship there. And then certainly premature infants, a lot of times they suffer from hypoxia during the birthing process or they just don't develop normally because they just don't have the time to spend in utero for normal neuromuscular development. And then in the prenatal period, maternal infections can also lead to cerebral palsy and those would include any of these infections that we wanna keep away from pregnant women which would be rubella, German measles, cytomegalovirus as well as chickenpox. Now neonatal jaundice is also linked to cerebral palsy because of the buildup of that bilirubin in the system and its effect on the brain and the brain development. And then certain maternal conditions are also linked to cerebral palsy which would be thyroid disorders or seizures specifically. So think about if the maternal metabolic rate is not controlled well, that can have effects on the fetus if there are thyroid disorders and then certainly if the mother suffers from seizures so maybe she suffers a seizure during while she is pregnant that can cause some hypoxia in the infant and then abnormal brain development. And then in the intrapartum period if there's a placental abruption, so all of a sudden the placenta detaches from the uterus causing bleeding which is usually a medical emergency and that infant has to be delivered emergently or if the umbilical cord is tangled in any way or maybe around the baby's neck that will lead to fetal hypoxia and that is also related to the development of cerebral palsy. No signs and symptoms of cerebral palsy might be again from mild to pretty severe and again it's usually neuromuscular. So initially it might be detected by the persistence of primitive reflexes. So that might be the rooting reflex persists past its normal time period or the pama grass reflex so any of those primitive reflexes that we typically assess for newborns are there in the newborn but then maybe at three or four or six months they persist so that should be a question mark that there's something going on in their development as well as the late growth motor movements. So if the patient is expected to start walking around the age of one years old and they are just now 18 months and there's absolutely no intention or no ability for this infant to start walking that should be a red flag that there might be some cerebral palsy going on as well as any kind of abnormal muscle tone that can lead even to spasticity. So that will usually mean that there is extreme contraction of certain muscles and when you can usually see that in the extremities that will lead to the patient not being able to extend or flex their extremities in a way that they would normally as well as ataxia so difficulty in gait if there is neuromuscular plop problems we can detect that. Patient might have seizures, they might be having signs and symptoms of ADHD as well as sensory impairment as we discussed over here hearing speech and visual and then speech and swallowing difficulties that can be detected. Diagnostic testing always involves EEG to see exactly the brain waves and measure those to see how is the communication happening from one side of the brain to the other ones that impulse is received. CT and MRI imaging studies of the brain to check for any underlying causes maybe tumors or malformations or signs of any abnormal development there. As well as BMP, we always wanna make sure that we check basic electrolyte panels because we know certain electrolytes are in charge of muscle control so if there's an abnormality there that might be the cause. We certainly wanna take a thorough history addressing all these prenatal intrapartum and postpartum conditions that might have led to cerebral palsy as well as a very detailed neurologic exam head to toe including all cranial nerves and then genetic testing will be done as well. Excuse me. Treatment usually is a multidisciplinary approach because many parts of the body are affected. So for the physical component there will be an orthopedic surgeon an orthopedist involved hopefully physical therapy and then if there's cognitive impairment neurologist might be involved as well as maybe a neurosurgeon as well as a speech therapist and occupational therapist and many more disciplines that can help this child achieve optimal function. And because the cause of this is basically abnormal muscle tone and spasticity because it's this chronic but non-progressive neuromuscular disorder. So this is something that's not going to get worse over time typically this spasticity is what it is and then it is treated as such and a very effective treatment is intrasecal baclofen. And baclofen is a muscle relaxing and intrasecal means that it is injected indirectly into the spinal cord to cause the relaxation of the muscle I'm sorry the nerve roots right there so that the muscles kind of relax and are not so spastic causing all the signs and symptoms and maybe some difficulty walking if the lower extremities are effective. Now benzodiazepines sometimes are given as well for spasticity and seizures but keep in mind benzodiazepines have a high risk for dependency so we always want to be extra careful with those. And Botox injections remember Botox basically relax the muscle they make it not so spastic and so they can relax it'll basically kind of freeze the muscle and then that also helps with spasticity. So thank you for watching this video on cerebral palsy please also see the other videos that refer to pediatric neurological disorders such as spina bifida and hydrocephalus in the pediatric playlist of my channel Nursing School Explained leave any comments down below I'm always happy to review those and if you have any specific topic you would like me to cover please put that in the comments as well and I'll be happy to address that. Thanks for watching.