Saturday, February 20, 2010

Cerebral palsy for adult neurologists: pearls

1.  Gross Motor Functional Classification System is most widely used

Level I  Ambulatory in all settings
Level II Walks without aids but has limitations in community settings
Level III Walks with aids
Level IV  Requires wheelchair or adult assistance
Level V  Fully dependent for mobility

Of all CP patients, 40 % are level I, and 66 % are levels 1-3 (ie. ambulatory)

2.  O CP patients, approximately one third will have spastic quadriplegia, one third spastic hemiplegia, one fifth spastic diplegia, and the rest either dyskinetic or ataxic-hypotonic CP.  It is rare for CP patients with spastic hemiplegia or spastic diplegia to be nonambulatory, but 75% of spastic quadriplegia patients are not ambulatory.  Those same patients are much more likely to suffer comorbidities such as epilepsy. 

3.  Genetic defects such as DCX and LISI can be sought, and coagulation pathway abnormalities (Leiden mutation eg.) among those suffering from placental thrombosis.

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