脑瘫

最后审阅: 1 十一月 2022
最后更新: 26 八月 2021

小结

定义

病史和体格检查

关键诊断因素

  • 存在的危险因素
  • 早期全身运动异常
  • HINE 评分异常
  • 运动发育落后
  • 语言发育落后
  • 认知/智力发育落后
  • 保留原始反射
  • 符合年龄的相应反射缺失
  • 痉挛/阵挛
  • 选择性自主运动控制能力受损
  • 走路垫脚/膝过伸
  • 剪刀步态
  • 蹲踞步态
  • 挛缩
更多 关键诊断因素

其他诊断因素

  • 肌无力
  • 关节不稳/错位
  • 肌张力障碍
  • 舞蹈病
  • 手足徐动症
  • 共济失调
  • 新生儿肌张力不全
  • 脊柱侧弯
其他诊断因素

危险因素

  • 早产
  • 低出生体重
  • 新生儿窒息
  • 多胎妊娠
  • 母体孕期疾病
  • 胎脑畸形
  • 重大出生缺陷
  • 家族性遗传代谢病
  • 新生儿期并发症
  • 脑膜炎
  • 孕期致畸原的暴露
  • 低等社会经济状况
  • 非头先露
  • 过期产
  • 头部损伤
更多 危险因素

诊断性检查

首要检查

  • 颅脑 MRI 扫描
更多 首要检查

需考虑的检查

  • 颅脑超声/CT
  • 凝血功能检查
  • 基因检测
  • 代谢筛查
  • 受累关节 X 线检查
  • 仪器化步态分析
更多 需考虑的检查

治疗流程

持续性治疗

痉挛型偏瘫

痉挛型双瘫

痉挛型四肢瘫

运动障碍型

合并共济失调

撰稿人

作者

UCLA/Orthopaedic Institute for Children Center for Cerebral Palsy, null

Los Angeles

CA

利益声明

See individual author disclosures.

William L. Oppenheim, MD
William L. Oppenheim

Distinguished Professor Emeritus Pediatric Orthopedics

Margaret Jones Kanaar Chair, Cerebral Palsy

David Geffen School of Medicine at UCLA

Los Angeles

CA

利益声明

WLO is an author of several references cited in this topic.

Loretta Staudt, MS, PT
Loretta Staudt

Research Physical Therapist

UCLA/Orthopaedic Institute for Children Center for Cerebral Palsy

David Geffen School of Medicine at UCLA

Los Angeles

CA

利益声明

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

利益声明

RT declares that she has no competing interests.

Marcia Greenberg, MS, PT
Marcia Greenberg

Physical Therapist

UCLA/Orthopaedic Institute for Children Center for Cerebral Palsy

David Geffen School of Medicine at UCLA

Los Angeles

CA

利益声明

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
Eileen Fowler

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

利益声明

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.

鸣谢

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.

利益声明

AS, EH, RH, JEH, TTN, and SC declare that they have no competing interests.

同行评议者

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

利益声明

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

利益声明

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

利益声明

CF declares that he has no competing interests.

  • 脑瘫 images
  • 鉴别诊断

    • 脊髓性肌萎缩症
    • 肌营养不良/肌病
    • 家族性/原发性肌张力不全
    更多 鉴别诊断
  • 指南

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  • 患者教育信息

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    脑性瘫痪:如何有效治疗?

    更多 患者教育信息
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