Cerebral Palsy: Ayu Insafi Mulyantari 12100118016 Novi Fauziah 12100118052 Preseptor: H. Satryo Waspodo, DR., SP - KFR

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CEREBRAL PALSY

Ayu Insafi Mulyantari 12100118016


Novi Fauziah 12100118052

Preseptor : H. Satryo Waspodo, dr., Sp.KFR


Anatomi
Anatomi
Anatomi
Cerebral palsy
Definisi

Merupakan defisit motorik yang


diakibatkan oleh kerusakan otak
selama kehamilan, atau karena
asfiksia perinatal

Klasfikasi
Physiology

■ Spasticity is defined as velocity-dependent increased muscle tone, determined by


passively flexing and extending muscle groups across a joint
■ Dyskinesia is defined as abnormal motor movements that become obvious when the
patient initiates a movement. When the patient is totally relaxed, usually in the supine
position, a full range of motion and decreased muscle tone may be found.
■ The hyperkinetic or choreoathetoid children show purposeless, often massive involuntary
movements with motor overflow; that is, the initiation of a movement of one extremity
leads to movement of other muscle groups.
■ The dystonic group manifest abnormal shifts of general muscle tone induced by
movement.
■ Patients with ataxias have a disturbance of the coordination of voluntary movements due
to muscle dyssynergia
Anatomy

■ Diplegia refers to involvement predominantly of the legs.


■ Quadriplegia refers to dysfunction of all four extremities
■ Triplegia one upper extremity might be less involved
■ Hemiplegia refers to individuals with unilateral motor dysfunction; and in most
children, the upper extremity is more severely involved than the lower.
■ Double hemiplegia upper extremities are much more involved than the lower
Etiologi
■ Prenatal (70%)
Infection, anoxia, toxic, vascular, Rh disease, genetic, congenital
malformation of brain
■ Natal (5-10%)
Anoxia, traumatic delivery, metabolic
■ Post natal
Trauma, infection, toxic
Manifestasi Klinik
 Postur tubuh yang abnormal
 Keterlambatan pencapaian ketrampilan baru sesuai dengan usia
anak (terlambat duduk, terlambat merangkak, dsb).
 Menetapnya perilaku infantil (bayi baru lahir) termasuk
menetapnya refleks primitif
 Adanya gambaran perkembangan motorik yang lain, yang tidak
seperti bayi /anak normal lainnya: hipertonus, hipotonus,
gerakan tidak terkendali, dsb
 Tanda-tanda lesi upper motor neuron
 Tidak ada uji laboratorium yang spesifik untuk CP
Diagnosis

■ The diagnosis of CP is established by a history that the child is “delayed” in motor


development, and the examination suggests that an abnormality of the brain is
responsible (increased deep tendon reflexes, ankle clonus, etc.).
■ Motor deficit :
■ Persistent primitive reflexes or the lack of development of the protective reflexes at
the expected time are important findings on the neurologic examination, suggesting
corticospinal tract impairment
Associated problems

■ Epilepsi
■ Retradarsi mental
■ Gangguan pengelihatan
■ Gangguan bicara
■ Gangguan pendengaran

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