Cerebral Palsy by F Miller

By F Miller

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With CP, knowing the cause does not help treat a child who has a dislocated hip. The treatment is based on the diagnosis of CP, as opposed to a muscle disease, spinal paralysis, or a progressive encephalopathy. The original cause of the CP does not matter. Therefore, the concept of “cerebral palsies” is not used in the remainder of this text, and the term cerebral palsy will not carry any information on specific etiology. Although the etiologic information has little relevance in the management of motor impairments, it is of limited importance in some children for giving a prognosis.

As the cells migrate into the correct position and initially form their synapses, many of these premature synapses need to be remodeled through the influence of external stimuli for normal function to develop. The classic demonstration of this principle was shown in the experiment in which eyes of kittens, one each kitten, were sewn closed at birth. 6 This experiment has become the basis for treating and understanding amblyopia, or lazy eye, in children. The synaptic remodeling and formation, also called synaptic plasticity in older ages, continues throughout life and is the basis for much of learning.

This image provides an excellent view of the ventricles and the periventricular white matter. This is the area where hemorrhages occur, and major risk factors for developing hemorrhages are younger gestational age and mechanical ventilation. Bleeding in the ventricle is called intraventricular hemorrhage (IVH), and bleeding in the periventricular area is called germinal matrix hemorrhage (GMH), or it may be combined in a term called periventricular-intraventricular hemorrhage (PIVH). 3). 9 However, different studies vary significantly, so good consensus values are not currently available.

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