Cerebral palsy
Download
Report
Transcript Cerebral palsy
CEREBRAL PALSY
By: Missy Kaplan
OUTLINE
Introduction to Cerebral Palsy
Epidemiology
Etiology
Treatment and Prevention
Dental Management
WHAT IS CEREBRAL PALSY
Affects body’s ability to control muscle movement
Results from an injury to the brain during
development.
This can occur prenatally, natally, or postnatally
(United Cerebral Palsy, 2011) (Wilkins, 2009)
TYPES
Spastic
Athetosis
constant, uncontrolled
movements.
Ataxic
involuntary contractions
of muscles causing
stiffness
loss of equilibrium and
have difficulty with
balance and coordination
Mixed
(United Cerebral Palsy, 2011)
(Wilkins, 2009)
EPIDEMIOLOGY
“an average of 1 in 303 children in the United
States have cerebral palsy”
“an estimated 800,000 children and adults in te
US are living with cerebral palsy”
Black and White children > Hispanic children
Boys > Girls
Spastic form is the most common accounting for
80% of all cases
(Centers for Disease Control and Prevention [CDC], 2011)
ETIOLOGY
Injury to the brain
Can occur up to age two
Causes
Hypoxia
Bleeding of the brain
Infections of the brain
Head injuries
Severe jaundice
Infections of mother during pregnancy
unknown
(PubMed Health, 2011)
RISKS
Low birth weight
Premature infants
Blood type incompatibility
Breech delivery
SYMPTOMS…..BESIDES MOTOR FUNCTION
Seizure disorders
Spinal deformities
Incontinence
Delayed growth and development
Mental retardation
Drooling
Impaired hearing, vision and speech
(National Institute for Neurological Disorders and Stroke [NINDS], 2011)
TYPES OF BRAIN DAMAGE
Periventricular leukomalacia
Cerebral dysgenesis
Abnormal formation of the brain
Intrapartum asphxia
Damage to the white matter
Lack of oxygen to the brain
Intracranial hemorrhage
Blocked or broken blood vessel
DIAGNOSIS
Doctor will monitor…if symptoms get worse…not
cerebral palsy
Magnetic resonance imaging (MRI)
Most common
Cranial ultrasound
No fine detail
High risk pregnancies
Computed tomography scan (CT)
TREATMENT
No cure
Aimed at managing symptoms
Team approach
(NINDS, 2011)
TREATMENT CONT.
Therapy!!!!
Physical
Occupational
Recreational
Speech
http://www.uthscsa.edu/mission/spring98/
horsestr.html
(NINDS, 2011)
TREATMENT CONT.
Medications
Glycopyrolate
Diazepam (Valium)
Baclofen
Dantrolene sodium
Tizanidine
reduces saliva
Treat stiff, rigid or
spastic muscles
(NINDS, 2011) (Rxlist, 2011)
SURGERY
Used when more conservative treatments fail
Orthopedic
Selective dorsal rhizotomy (SDR)
Locate overactive nerve and sever
Spinal cord stimulation
an electrode is implanted at the base of the spinal
cord and stimulates the nerve
(NINDS, 2011)
http://www.liddlekidz.com/cerebral-palsy-massage-course.html
ORAL HEALTH
Malocclusion
Facial muscle disturbances
Attrition
Fractured teeth
Dental caries
Periodontal disease
(Wilkins, 2009)
DENTAL MANAGEMENT
Do not force limbs
Place patients head in middle of chair
Watch and anticipate movements
Place patients chin down
No sudden movements
Tone down lights
Early appointments
Possible sedation
Nitrous
(Waldman, B.H., Borg, P.A., & Perlman, S.P., 2011)
(Kaufman, E., Meyer S., Wolnerman, J.S., Gilai, A.N., 1991)
(Oklahoma Association of Community Action Agencies, 2008).
CONCLUSION
The dental office can be a very stressful place and
in order to make it less stressful, we need to
understand cerebral palsy and know how to
manage their dental care.
REFERENCES
Centers for Disease Control and Prevention. (2011). Cerebral palsy. Retrieved on
November 5, 2011 from http://www.cdc.gov/ncbddd/cp/data.html
Kaufman, E., Meyer S., Wolnerman, J.S., Gilai, A.N. (1991). Transient suppression of
involuntary movements in cerebral palsy patients during dental treatment.
American Dental Society of Anesthesiology. 38: 200-205
National Institute for Neurological Disorders and Stroke. (2011). Cerebral palsy:
hope through research. Retrieved on November 11, 2011 from
http://www.ninds.nih.gov/disorders/cerebral_palsy/detail_cerebral_palsy.htm#179283
104
Oklahoma Association of Community Action Agencies. (2008). Oral health care for
children with special health care needs. Retrieved on November 11, 2011 from
http://www.okacaa.org/8.5%20x%2011%20Oral%20Health%20Care%20for%20Childr
en%20with%20Special%20Health%20Care%20Needs.pdf
PubMed Health. (2011). Cerebral palsy. Retrieved on November 11, 2011 from
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001734/
RxList (2011) RxList Inc. Retrieved on November 11, 2011 from
http://www.rxlist.com/script/main/hp.asp
United Cerebral Palsy. (2011). Retrieved on November 5, 2011 from
http://www.ucp.org/uploads/media_items/cerebral-palsy-fact-sheet.original.pdf
Waldman, B.H., Borg, P.A., & Perlman, S.P. (2011). Periodontal care for patients
with special needs. Dimensions of Dental Hygiene. 9(9): 78-80, 83.
Wilkins, E.M. (2009). Clinical practice of the dental hygienist. (10 ed., pp 925-928).
Baltimore: Lipincott Williams and Wilkins