Resumo
Definição
História e exame físico
Principais fatores diagnósticos
- presença de fatores de risco
- anormalidades precoces no movimento em geral
- escores de HINE anormais
- atraso no desenvolvimento motor
- atraso no desenvolvimento da fala
- atraso no desenvolvimento cognitivo/intelectual
- retenção dos reflexos primitivos
- ausência de reflexos apropriados para a idade
- espasticidade/clônus
- deficiência seletiva do controle motor voluntário
- marcha digitígrada/hiperextensão do joelho
- marcha em tesoura
- marcha em agachamento
- contraturas
Outros fatores diagnósticos
- fraqueza muscular
- instabilidade/luxação articular
- distonia
- coreia
- atetose
- ataxia
- hipotonia neonatal
- escoliose
Fatores de risco
- prematuridade
- baixo peso ao nascer
- asfixia fetal ao nascimento
- nascimentos múltiplos
- doença materna
- malformação cerebral fetal
- grandes malformações congênitas
- distúrbio metabólico/genético familiar
- complicações neonatais
- meningite
- exposição teratogênica materna
- condição socioeconômica baixa
- apresentação anômala (outra que não de vértice)
- pós-datismo
- traumatismo cranioencefálico
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- ressonância nuclear magnética (RNM) cranioencefálica
Investigações a serem consideradas
- ultrassonografia/tomografia computadorizada (TC) cranioencefálica
- exames de coagulação
- teste genético
- triagem metabólica
- raio-x da articulação afetada
- análise instrumental da marcha
Algoritmo de tratamento
hemiplegia espástica
diplegia espástica
quadriplegia espástica
discinético
atáxico
Colaboradores
Autores
UCLA/Orthopaedic Institute for Children Center for Cerebral Palsy, null
Los Angeles
CA
Declarações
See individual author disclosures.
William L. Oppenheim, MD
Distinguished Professor Emeritus Pediatric Orthopedics
Margaret Jones Kanaar Chair, Cerebral Palsy
David Geffen School of Medicine at UCLA
Los Angeles
CA
Declarações
WLO is an author of several references cited in this topic.
Loretta Staudt, MS, PT
Research Physical Therapist
UCLA/Orthopaedic Institute for Children Center for Cerebral Palsy
David Geffen School of Medicine at UCLA
Los Angeles
CA
Declarações
LS is a clinical evaluator for several sponsored clinical trials as part of her salaried employment at UCLA. She has received travel, meals, and accomodation to attend training meetings for some of these trials but does not receive any direct reimbursements or personal benefits from the companies, which include Pfizer, Sarepta, Audentes Therapeutics, Bristol-Meyers Squibb, Biogen, Santhera, Fibrogen, Cytokinetics, Italfarmaco, and AveXis. As part of her salaried employment at UCLA, LS is working on a project funded by the Cerebral Palsy Foundation. She is an author of several references cited in this topic.
Rachel Thompson, MD
Assistant Professor-in-Residence, Department of Orthopaedic Surgery
Associate Residency Program Director, Department of Orthopaedic Surgery
Director, UCLA/Orthopaedic Institute for Children Center for Cerebral Palsy
William and Patricia Oppenheim Presidential Chair in Pediatric Orthopaedics
David Geffen School of Medicine at UCLA
Los Angeles
CA
Declarações
RT declares that she has no competing interests.
Marcia Greenberg, MS, PT
Physical Therapist
UCLA/Orthopaedic Institute for Children Center for Cerebral Palsy
David Geffen School of Medicine at UCLA
Los Angeles
CA
Declarações
MG is a consultant for the NGO, UCP Wheels for Humanity, teaching physical therapists in developing countries. She is an author of several references cited in this topic.
Eileen Fowler, PhD, PT
Professor
Department of Orthopaedic Surgery
Director of Research and Education
UCLA/Orthopaedic Institute for Children Center for Cerebral Palsy
Peter William Shapiro Chair
David Geffen School of Medicine at UCLA
Los Angeles
CA
Declarações
EF receives grant funding from the Cerebral Palsy Foundation. She is a member of the Scientific Advisory Committee of the Cerebral Palsy Foundation. She is an author of several references cited in this topic.
Agradecimentos
Dr William L. Oppenheim, Loretta Staudt, Dr Rachel Thompson, Marcia Greenberg, and Dr Eileen Fowler wish to gratefully acknowledge Dr Albert Stroberg, Dr Erika Hassan, Dr Rebecca Hanson, Dr Joan Earle Hahn, Dr Tien T. Nguyen, and Dr Sarah Copeland, previous contributors to this topic.
Declarações
AS, EH, RH, JEH, TTN, and SC declare that they have no competing interests.
Revisores
Hank Chambers, MD
Clinical Professor
Department of Orthopaedic Surgery
University of California at San Diego
Medical Affairs Officer
Rady Children's Hospital
San Diego
CA
Declarações
HC is an author of a number of references cited in this topic. He has received research support from the National Institutes of Health greater than 6 figures USD.
Michael Sussman, MD
Orthopaedic Surgeon
Shriners Hospital for Children
Portland
OR
Declarações
MS declares that he has no competing interests.
Charles Fairhurst, MBBS MSc
Consultant in Paediatric Neurodisability
Evelina Children's Hospital
Guy's & St Thomas' NHS Foundation Trust
London
UK
Declarações
CF declares that he has no competing interests.
Diagnósticos diferenciais
- Atrofia muscular espinhal
- Distrofia muscular/miopatia
- Distonia familiar/primária
Mais Diagnósticos diferenciaisDiretrizes
- Providing a primary care medical home for children and youth with cerebral palsy
- Prevention and management of respiratory disease in young people with cerebral palsy: consensus statement
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