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
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
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
诊断性检查
首要检查
- 颅脑 MRI 扫描
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
治疗流程
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
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
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
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
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.
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
- 对早产风险女性给予硫酸镁以对胎儿提供神经保护
- 年轻脑性瘫痪患者呼吸系统疾病的预防和管理：共识声明
更多 指南患者教育信息
脑性瘫痪：是什么？
脑性瘫痪：如何有效治疗？
更多 患者教育信息
登录或订阅即可浏览 BMJ Best Practice 临床实践完整内容
内容使用需遵循免责声明