Introduction to Cerebral Palsy Written and Reviewed by the My Child Without Limits Advisory Committee
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Detrusor Sphincter Dyssynergia: a Review of Physiology, Diagnosis, and Treatment Strategies
Review Article Detrusor sphincter dyssynergia: a review of physiology, diagnosis, and treatment strategies John T. Stoffel Department of Urology, University of Michigan, Ann Arbor, MI, USA Correspondence to: John T. Stoffel, MD. Department of Urology, University of Michigan, Ann Arbor, MI, USA. Email: [email protected]. Abstract: Detrusor sphincter dyssynergia (DSD) is the urodynamic description of bladder outlet obstruction from detrusor muscle contraction with concomitant involuntary urethral sphincter activation. DSD is associated with neurologic conditions such as spinal cord injury, multiple sclerosis, and spina bifida and some of these neurogenic bladder patients with DSD may be at risk for autonomic dysreflexia, recurrent urinary tract infections, or upper tract compromise if the condition is not followed and treated appropriately. It is diagnosed most commonly during the voiding phase of urodynamic studies using EMG recordings and voiding cystourethrograms, although urethral pressure monitoring could also potentially be used. DSD can be sub-classified as either continuous or intermittent, although adoption of this terminology is not widespread. There are few validated oral pharmacologic treatment options for this condition but transurethral botulinum toxin injection have shown temporary efficacy in reducing bladder outlet obstruction. Urinary sphincterotomy has also demonstrated reproducible long term benefits in several studies, but the morbidity associated with this procedure can be high. Keywords: Detrusor sphincter dyssynergia (DSD); neurogenic bladder; urodynamics; external urinary sphincter (EUS) Submitted Nov 30, 2015. Accepted for publication Jan 05, 2016. doi: 10.3978/j.issn.2223-4683.2016.01.08 View this article at: http://dx.doi.org/10.3978/j.issn.2223-4683.2016.01.08 Introduction Physiology The human bladder has two functions—to store and During storage of urine, afferent nerves carry information empty urine. -
Acute Cerebellar Ataxia Associated with Intermittent ECG Pattern Similar to Wellens Syndrome and Transient Prominent QRS Anterior Forces
Acute cerebellar ataxia associated with intermittent ECG pattern similar to Wellens syndrome and transient prominent QRS anterior forces Andrés Ricardo Pérez-Riera, MD, PhD. Post-Graduates Advisor at Design of Studies and Scientific Writing Laboratory in the ABC Faculty of Medicine - ABC Foundation - Santo André – São Paulo – Brazil Raimundo Barbosa-Barros, MD. Specialist in Cardiology by the Brazilian Society of Cardiology (SBC) Specialist in Intensive Care by the Sociedade Brasileira de Terapia Intensiva Chief of the Coronary Center of the Hospital de Messejana Dr. Carlos Alberto Studart Gomes. Fortaleza - Brazil Adrian Baranchuk, MD FACC FRCPC Associate Professor of Medicine and Physiology - Cardiac Electrophysiology and Pacing - Director, EP Training Program - Kingston General Hospital - FAPC 3, 76 Stuart Street K7L 2V7, Kingston ON Queen's University - Canada Male patient, 56 years old, white, uncontrolled hypertension, was admitted to our emergency department (ED) with reports of sudden dizziness, headache of abrupt onset, nausea, vomiting and weakness in the lower limbs. Physical examination drew attention to the presence of manifestations suggestive of cerebellar syndrome: impaired coordination in the trunk or arms and legs, inability to coordinate balance, gait, extremity, uncontrolled or repetitive eye movements, (nystagmus), dyssynergia, dysmetria, dysdiadochokinesia, dysarthria (cerebellar ataxia). Normal myocardial necrosis markers and normal electrolytes ECO 1: anteroseptal-apical akinesis; LVEF = 30% ECO 2 (third day): -
The Epidemiology of the Cerebral Palsies
Clinics in Developmental Medicine No. 87 The Epidemiology of the Cerebral Palsies Edited by FIONA STANLEY EVA ALBERMAN 1984 Spastics International Medical Publications OXFORD: Blackwell Scientific Publications Ltd. PHILADELPHIA: J. B. Lippincott Co. CHAPTER 11 Prenatal and Perinatal Risk Factors in a Survey of 681 Swedish Cases BENGT and GUDRUN HAGBERG I, that am curtail'd of this fair proportion, Cheated of feature by dissembling nature, , Deform'd, unfinish'd, sent before my time Into this breathing world, scarce half made up, And that so lamely and unfashionable That dogs bark at me, as I halt by them. Shakespeare, Richard III Introduction The aim of this chapter is to try and shed light on more specific aspects of the main groups of prenatal causes and risk factors for cerebral palsy, their mutual importance, and particularly their relationship to superimposed detrimental perinatal events. This survey is based on an investigation of 681 cases born in Sweden from 1959 to 1976. In our original retrospective analysis of causes of cerebral palsy (Hagberg et al. 1975a), it was found necessary to make certain generalisations about the aetiological groupings. Only the risk factor that was considered to be the predominating possible cause was used for classification. There is no doubt that this oversimplifies the issue as it neglects the complex network of different interacting detrimental risk factors that are present in the majority of cases, and in all probability underlie the development of brain lesions. Definitions For the purpose of the Swedish investigation, the following definition of cerebral palsy was used: a non-progressive 'disorder of movement and posture due to a defect or lesion of the immature brain' (Bax 1964). -
Program-2018.Pdf
0 Welcome to our 2018 conference! We are glad that you GENERAL INFORMATION are here. We would like to take an opportunity to Signing in: Nurses and ADRS employees are required to acknowledge the following organizations for their financial sign in at the CE registration table. support: Nametags will be issued at conference registration. You • United Cerebral Palsy of Alabama must have your nametag to attend sessions. • Alabama Department of Early Childhood Education • Alabama Department of Education/SES Seating: Some sessions will have limited space due to • Alabama Department of Mental Health room size. Seating will be on a first come basis. • Alabama Department of Rehabilitation Services/Alabama’s Early Intervention System Handouts: In general, handouts will not be provided on • Alabama Institute for the Deaf and Blind site, but for those presenters who submit handouts, they • Therap Services are or will be available on the conference website at www.ucpalabama.org/conference. We also would like to recognize the following individuals who volunteered their expertise, time, energy, and Exhibitors: Many marvelous exhibits will be available for resources to ensure a quality conference experience for all! you. Please visit them during your break. 2018 Planning Committee: Legislative initiative: The “Write Your Legislator” central • Deana Aumalis, University of AL Huntsville station will be at the registration area. We encourage • Isaac Beavers, Alabama Institute for Deaf/Blind everyone to visit the booth to participate in our “Pinning • Tania Baldwin, Alabama's EI System Their Future on You” campaign. We will print out a copy of • Amy Blakeney, Alabama’s EI System your legislator contact information, have cards there for • Sheila Bolling, Alabama Dept of Education/SES you to write a note to your legislator, and mail your card for you. -
10Neurodevelopmental Effects of Childhood Exposure to Heavy
Neurodevelopmental E¤ects of Childhood Exposure to Heavy Metals: 10 Lessons from Pediatric Lead Poisoning Theodore I. Lidsky, Agnes T. Heaney, Jay S. Schneider, and John F. Rosen Increasing industrialization has led to increased exposure to neurotoxic metals. By far the most heavily studied of these metals is lead, a neurotoxin that is particularly dangerous to the developing nervous system of children. Awareness that lead poison- ing poses a special risk for children dates back over 100 years, and there has been increasing research on the developmental e¤ects of this poison over the past 60 years. Despite this research and growing public awareness of the dangers of lead to chil- dren, government regulation has lagged scientific knowledge; legislation has been in- e¤ectual in critical areas, and many new cases of poisoning occur each year. Lead, however, is not the only neurotoxic metal that presents a danger to children. Several other heavy metals, such as mercury and manganese, are also neurotoxic, have adverse e¤ects on the developing brain, and can be encountered by children. Al- though these other neurotoxic metals have not been as heavily studied as lead, there has been important research describing their e¤ects on the brain. The purpose of the present chapter is to review the neurotoxicology of lead poisoning as well as what is known concerning the neurtoxicology of mercury and manganese. The purpose of this review is to provide information that might be of some help in avoiding repeti- tion of the mistakes that were made in attempting to protect children from the dan- gers of lead poisoning. -
Neurogenic Bowel Dysfunction in Patients with Multiple Sclerosis Open Access to Scientific and Medical Research DOI
Journal name: Degenerative Neurological and Neuromuscular Disease Article Designation: Review Year: 2018 Volume: 8 Degenerative Neurological and Neuromuscular Disease Dovepress Running head verso: Preziosi et al Running head recto: Neurogenic bowel dysfunction in patients with multiple sclerosis open access to scientific and medical research DOI: http://dx.doi.org/10.2147/DNND.S138835 Open Access Full Text Article REVIEW Neurogenic bowel dysfunction in patients with multiple sclerosis: prevalence, impact, and management strategies Giuseppe Preziosi Abstract: Bowel dysfunction in patients with multiple sclerosis (MS) is highly prevalent. Ayeshah Gordon-Dixon Constipation and fecal incontinence can coexist and alternate, impacting on the patient’s quality Anton Emmanuel of life and social interactions, as well as burdening the caregivers. The cost for the health care providers is also significant, with increased number of hospital admissions, treatment-related Gastro-Intestinal Physiology Unit, University College London Hospital, costs, and hospital appointments. The origin is multifactorial, and includes alteration of neu- London, UK rological pathways, polypharmacy, behavioral elements, and ability to access the toilet. Every patient with MS should be sensitively questioned about bowel function, and red flag symptoms should prompt adequate investigations. Manipulation of life style factors and establishment of a bowel regime should be attempted in the first place, and if this fails, other measures such For personal use only. as biofeedback and transanal irrigation should be included. A stoma can improve quality of life, and is not necessarily a last-ditch option. Antegrade colonic enemas can also be an effec- tive option, whilst neuromodulation has not proved its role yet. Effective treatment of bowel dysfunction improves quality of life, reduces incidence of urinary tract infection, and reduces health care costs. -
Child Neurology: Hereditary Spastic Paraplegia in Children S.T
RESIDENT & FELLOW SECTION Child Neurology: Section Editor Hereditary spastic paraplegia in children Mitchell S.V. Elkind, MD, MS S.T. de Bot, MD Because the medical literature on hereditary spastic clinical feature is progressive lower limb spasticity B.P.C. van de paraplegia (HSP) is dominated by descriptions of secondary to pyramidal tract dysfunction. HSP is Warrenburg, MD, adult case series, there is less emphasis on the genetic classified as pure if neurologic signs are limited to the PhD evaluation in suspected pediatric cases of HSP. The lower limbs (although urinary urgency and mild im- H.P.H. Kremer, differential diagnosis of progressive spastic paraplegia pairment of vibration perception in the distal lower MD, PhD strongly depends on the age at onset, as well as the ac- extremities may occur). In contrast, complicated M.A.A.P. Willemsen, companying clinical features, possible abnormalities on forms of HSP display additional neurologic and MRI abnormalities such as ataxia, more significant periph- MD, PhD MRI, and family history. In order to develop a rational eral neuropathy, mental retardation, or a thin corpus diagnostic strategy for pediatric HSP cases, we per- callosum. HSP may be inherited as an autosomal formed a literature search focusing on presenting signs Address correspondence and dominant, autosomal recessive, or X-linked disease. reprint requests to Dr. S.T. de and symptoms, age at onset, and genotype. We present Over 40 loci and nearly 20 genes have already been Bot, Radboud University a case of a young boy with a REEP1 (SPG31) mutation. Nijmegen Medical Centre, identified.1 Autosomal dominant transmission is ob- Department of Neurology, PO served in 70% to 80% of all cases and typically re- Box 9101, 6500 HB, Nijmegen, CASE REPORT A 4-year-old boy presented with 2 the Netherlands progressive walking difficulties from the time he sults in pure HSP. -
Accelerating Research. Empowering Families
RESEARCH STRATEGY AND MISSION We aggressively pursue research to identify treatments and a cure for Rett syndrome. New Mecp2 female mouse model developed AMO receives FDA Orphan Drug Designation 2018 + BEYOND With your support, we can Neuren begins plans for trofinetide Phase 3 continue to blaze a trail in Rett syndrome research and family 2017 14 clinics designated empowerment to transform lives. as Rett Syndrome Clinical Research First multi-site, Centers of Excellence multi-country clinical Join us in our mission: trial begins: sarizotan • Make a donation 2015 • Coordinate a Fundraiser Clinical trial for • Participate in an Event trofinetide begins • Advocate for Rett syndrome NIH funding of the NHS begins Visit www.rettsyndrome.org or Drug screening Scout program begins call 1.800.719.8214 2014 First multi-site clinical trial Rettsyndrome.org is a 501(c)3 organization in RTT begins: NNZ-2566 (trofinetide) Accelerating dedicated to accelerating research for treatments and a cure for Rett syndrome and related disorders, 2013 while providing family empowerment. As a Established stem Research. leading organization for Rett syndrome research, cell model for Rettsyndrome.org is committed to funding high- drug screening First clinical trial quality, peer-reviewed research grants and programs. in RTT supported by Rettsyndrome.org: IGF-1 Empowering Genetic manipulation 2010 and biochemical Families. intervention improve Rett-like symptoms in a mouse model 2007 4600 Devitt Drive Cincinnati, OH 45246-1104 ‘‘ (800) 818-7388 www.rettsyndrome.org I am very thankful that Rettsyndrome.org has taken such a strong leadership role /rettsyndrome /rettsyndrome /rettsyndromeorg with advancing research. Their progress to get trofinetide to market is very exciting as it could finally be an answer to relieving some of Jill’s daily struggles. -
8. Eligibility for Special Education Services A
8. Eligibility for Special Education Services a. Fact Sheets on i. ADHD Fact Sheet on Disabilities from NICHCY (http://nichcy.org/disability) ii. Autism Spectrum Disorders Fact Sheet iii. Blindness/Visual Impairment Fact Sheet iv. Cerebral Palsy Fact Sheet v. Deaf-Blindness Fact Sheet vi. Deafness and Hearing Loss Fact Sheet vii. Developmental Delay Fact Sheet viii. Down Syndrome Fact Sheet ix. Emotional Disturbance Fact Sheet x. Epilepsy Fact Sheet xi. Intellectual Disabilities Fact Sheet xii. Learning Disabilities Fact Sheet xiii. Other Health Impairment Fact Sheet xiv. Traumatic Brain Injury Fact Sheet b. Disability Worksheets for Eligibility for Special Education (from OSSE/DCPS) i. Other Health Impairment Disability Worksheet ii. Specific Learning Disability Worksheet iii. Emotional Disturbance Disability Worksheet Attention-Deficit/ Hyperactivity Disorder NICHCY Disability Fact Sheet #19 Updated March 2012 break down his lessons into gets to choose something fun several parts. Then they have he’d like to do. Having a him do each part one at a child with AD/HD is still a Mario’s Story time. This helps Mario keep challenge, but things are his attention on his work. looking better. Mario is 10 years old. When he was 7, his family At home, things have learned he had AD/HD. At changed, too. Now his What is AD/HD? the time, he was driving parents know why he’s so everyone crazy. At school, he active. They are careful to Attention-deficit/hyperac- couldn’t stay in his seat or praise him when he does tivity disorder (AD/HD) is a keep quiet. At home, he something well. -
Hereditary Spastic Paraparesis: a Review of New Developments
J Neurol Neurosurg Psychiatry: first published as 10.1136/jnnp.69.2.150 on 1 August 2000. Downloaded from 150 J Neurol Neurosurg Psychiatry 2000;69:150–160 REVIEW Hereditary spastic paraparesis: a review of new developments CJ McDermott, K White, K Bushby, PJ Shaw Hereditary spastic paraparesis (HSP) or the reditary spastic paraparesis will no doubt Strümpell-Lorrain syndrome is the name given provide a more useful and relevant classifi- to a heterogeneous group of inherited disorders cation. in which the main clinical feature is progressive lower limb spasticity. Before the advent of Epidemiology molecular genetic studies into these disorders, The prevalence of HSP varies in diVerent several classifications had been proposed, studies. Such variation is probably due to a based on the mode of inheritance, the age of combination of diVering diagnostic criteria, onset of symptoms, and the presence or other- variable epidemiological methodology, and wise of additional clinical features. Families geographical factors. Some studies in which with autosomal dominant, autosomal recessive, similar criteria and methods were employed and X-linked inheritance have been described. found the prevalance of HSP/100 000 to be 2.7 in Molise Italy, 4.3 in Valle d’Aosta Italy, and 10–12 Historical aspects 2.0 in Portugal. These studies employed the In 1880 Strümpell published what is consid- diagnostic criteria suggested by Harding and ered to be the first clear description of HSP.He utilised all health institutions and various reported a family in which two brothers were health care professionals in ascertaining cases aVected by spastic paraplegia. The father was from the specific region. -
Outcomes Following Unilateral Selective Dorsal Rhizotomy In
Outcomes and Perioperative Considerations for Unilateral Selective Dorsal Rhizotomy in Children with Spastic Hemiplegia with Pre- and Postoperative Quantitative Gait Analysis Christine Hunt, D.O.1, Nicholas Wetjen, M.D.2, Kenton Kaufman, Ph.D.3, Krista Coleman Wood, P.T., Ph.D.3, Joline Brandenburg, M.D.1, Bradford Landry, D.O.1 1Department of Physical Medicine & Rehabilitation, 2Department of Neurologic Surgery, 3Department of Orthopedic Surgery Mayo Clinic, Rochester, MN Abstract Background & Objectives Methods Results: Postoperative Gait Analysis Discussion Background: Selective dorsal rhizotomy (SDR) is a Background Preoperative Baseline Characteristics Patient 1: Right SDR December 2013 • Pre-SDR, patients undergo an in-depth review of their medical procedure used to improve function, decrease pain and • Several human trials examining outcomes in SDR in children • Patient 1: 6 year old male, spastic right hemiplegia • 62.5% of sensory dorsal rootlets sectioned ( L2 to S1) history and imaging studies, consultation with a physiatrist, reduce spasticity in children and adults with cerebral palsy or neurosurgeon, and orthopedic surgeon, and evaluation with PT with spastic diplegia have been conducted, but there is a • GMFCS Level II • Normalized velocity and stride length stroke. Positive outcomes have been reported by numerous and OT. Testing includes QGA, MRI lumbar spine and brain, paucity of data describing outcomes following SDR for • 12 series of botulinum toxin • Improved hip and knee kinematics and kinetics authors but pediatric -
The Children's Center at UCP Education Reopening Plan September 2020
The Children’s Center at UCP United Cerebral Palsy Association of Greater Suffolk, Inc. Education Reopening Plan September 2020 TABLE OF CONTENTS TABLE OF CONTENTS ...................................................................... 1 INTRODUCTION …………………………………………………………2 COMMUNICATION/FAMILY AND COMMUNITY ENGAGEMENT……………5 HEALTH AND SAFETY………………………………………………….13 FACILITIES……………………………………………………………..27 NUTRITION……………………………………………………………..28 TRANSPORTATION…………………………………………………….29 SOCIAL AND EMOTIONAL WELL BEING………………………….…….30 SCHOOL SCHEDULES ……………………………………..…………..33 ATTENDANCE & CHRONIC ABSENTEEISM……………….……………37 TECHNOLOGY AND CONNECTIVITY……………..……………………..41 TEACHING AND LEARNING…………………………….………………46 SPECIAL EDUCATION…………………………………………………..49 1 INTRODUCTION It is difficult to comprehend how much our world has changed since March of 2020. The COVID-19 pandemic has impacted our students, their families, our staff and our schools in ways many of us have yet to fully understand. At these unprecedented times, we must reflect on the end of the 2019-20 school year to learn from our decisions to help inform our actions for the year ahead. There is no doubt that the 2020-21 school year will provide its own set of unique challenges. It is our goal to utilize this document to prepare our staff, students, families and partner Counties and School Districts for the wide variety of situations that we may face in the year ahead. This document was developed through the collective efforts of United Cerebral Palsy Association of Greater Suffolk, Inc., The Children’s