The early management of cerebral palsy.
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Explore the source record for details and available documents.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
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Explore the source record for details and available documents.
This report investigates the effectiveness of biofeedback in the treatment of poor head-positioning in patients with cerebral palsy. Four patients were given feedback of head-position trainer: two were given 20 sessions, the other two were given 10 sessions followed by 10 sessions of social reinforcement. It was found that biofeedback produced significant changes in head control during therapy but that these did not transfer well to other situations, nor did it result in long-term positive improvement. The use of social reinforcement produced excellent and long-term gains. These results are discussed in terms of stimulus properties and reinforcement conditions. General implications of this study in relation to the generalisation and maintenance of behaviour change are also discussed.
Twenty-four children with spastic or athetoid quadriplegic cerebral palsy were paired according to severity of motor disability and age, then matched with 12 non-handicapped children of similar ages. The children were tested with a standard kinesthesiometer and two kinds of scores were recorded. Absolute Error scores reflected the children's deviation from the target and Total Movement scores reflected their over-all range of movement. There were significant differences between groups in Absolute Error scores, with the cerebral-palsied children performing worse than the controls and the spastic children worse than the athetoid children. All three groups tended to underestimate the targets and there were no significant differences in Total Movement scores.
Sixty-two patients with cerebral palsy seen consecutively in a pediatric neurology practice were submitted to a prospective protocol which tabulated their neurological findings, birth and developmental histories and an extensive neurodevelopmental pedigree. Their family histories were compared with those of three control groups, consisting of 62 children with headaches, 62 with school/behavior problems and 62 random normal children. The family histories of the cerebral-palsied children revealed an unusual number of relatives with cerebral palsy, mental retardation and seizures. This study suggests that a large proportion of cerebral-palsied individuals may be predisposed to aplasia/hypoplasia of neural tissue. Some affected by presumably static 'brain-damage' may in later years develop indolent degenerative disease. Indirect genetic factors may also play a major predisposing role in cerebral palsy of proven postnatal/perinatal onset.
Two children with clinical pictures of paroxysmal kinesinogenic choreoathetosis and paroxysmal dystonic choreoathetosis are described and compared with previous reports with regard to diagnostic procedures, therapeutic approach and prognosis. A third case, characterized by paroxysmal dyskinesia induced by exercise and associated with choreiform nonprogressive signs, is also described. Such an association has not been reported previously. This unusual clinical picture indicates the possibility of intermediate forms in the paroxysmal choreoathetosis group and suggests a relationship between paroxysmal motor disorders and benign familial chorea with early onset.
The motor function of 35 children with athetoid cerebral palsy was examined retrospectively using videotape recordings made at five to eight months of age. Many infants showed asymmetric tonic neck, Moro and Galant reflexes. Movements shown to be difficult included: keeping a symmetric supine posture, isolated movements of the hips and knees, forward extension of the upper extremity, extension of neck and trunk in the prone position and in ventral suspension, flexion of the neck in the traction response, and weight support by the upper extremities. Asymmetric or excessive opening of the mouth was present in all infants. The grade of difficulty for each posture and movement might reflect subsequent motor disability at three years of age.