By Freeman Miller
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Extra resources for Physical Therapy of Cerebral Palsy
1 A large and variable group of children have differing degrees of cortical dysgenesis, which is a disorder of brain cortex formation. This disorder may be called focal cortical dysplasia and presents mainly with seizure disorders. The motor effects may vary from none to very severe and from hypotonia to hypertonia. Another part of normal development of the brain in the neonatal and prenatal period requires formation of the synapses and then subsequent remodeling of this neuronal synapse formation.
This kind of detail gives families a sense that there is someone in charge with experience in dealing with these complications and helps them deal with the fear of the unknown, which the complications often bring to the foreground. Complications need to be recorded in detail in the medical record and should reflect all the objective observations and alternatives that were considered. This record is not the place where blame should be directed. What is observed to have occurred should be documented objectively without rewriting history.
Anatomic Classification The most useful primary classification for children with CP is based on the anatomic pattern of involvement. This involvement is the first classification used by physicians treating motor impairments, as it gives a very general sense of severity and a general overview of what patients’ problems likely are. Classification into hemiplegia, which involves one half of the body; diplegia, which involves primarily the lower extremities with mild upper extremity involvement; and quadriplegia, which involves all four limbs, is most useful.
Physical Therapy of Cerebral Palsy by Freeman Miller