Recognition of CP cerebral palsy disease (CP mimic)

Author: darkpigx Source: "I can still eat a small fish and worm" Public account Definition of cerebral palsy Cerebral palsy (cerebral palsy, CP) referred to as cerebral palsy, is a group of non-progressive brain damage caused by the developing fetus or infant A syndrome of persistent, developmental motor and postural disorders, resulting in limited mobility; often with sensory, perceptual, cognitive, communication, and behavioral impairments, as well as epilepsy and secondary musculoskeletal problems
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Classification of cerebral palsy ➤Clinically divided into the following types according to the characteristics of movement disorders: ➤Spastic type (70%~80%): the pyramidal tract is mainly involved, with speed-dependent muscle tone increase, spastic posture, selective movement limitation and Characterized by pathological reflexes; ➤ Involuntary movement type (10%~20%): The extrapyramidal system is mainly involved, characterized by unstable muscle tension, asymmetric posture and involuntary movements, which can be manifested as dystonia, dance ‐ Athetosis; ➤ Ataxia (about 5%): The cerebellum is mainly involved, and is characterized by hypotonia, balance and ataxia, slow motor initiation and poor coordination; ➤ Mixed type: can be any of the above two A mix of types emerges
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➤ According to the affected limbs, it is divided into: ➤ Monoplegia: a single limb is involved; ➤ Diplegia: The lower limb is mainly involved; ➤ Hemiplegia: One limb is involved; ➤ Quadriplegia: All limbs are involved
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The etiology of cerebral palsy leading to the pathogenesis of CP is still unclear, but many high-risk factors related to CP have been gradually discovered clinically
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Non-genetic risk factors for CP are still the most important.
According to the characteristics of time, these factors can be divided into three parts: prenatal, intrapartum, postpartum and infancy
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➤Prenatal (mainly among them): intrauterine infection, intrauterine growth malformation, intrauterine growth retardation, multiple pregnancy, placental insufficiency, improper medication during pregnancy, exposure to chemical or radioactive substances during pregnancy, threatened abortion, blood loss during pregnancy, Cholestasis during pregnancy, decreased amniotic fluid volume, etc.
; ➤ During delivery: premature birth, low birth weight, neonatal asphyxia and hypoxic ischemic encephalopathy (HIE), cesarean section, head birth injury, etc.
➤ Postpartum: intracranial infection, Brain trauma, hypoglycemia, hypoxia-ischemia, hydrocephalus, stroke, etc.
➤Infancy: various encephalitis or encephalopathy, poisoning, trauma, stroke
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➤The main concept of genetic etiology of CP (20%-30%) includes the following two parts: (1) genetic causes lead to non-progressive cerebral dysplasia resulting in cerebral palsy; (2) genetic susceptibility makes children more prone to cerebral palsy Cerebral palsy occurs when brain damage occurs in certain circumstances
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Recognition of Cerebral Palsy-like Disorders In the past, CP was mainly classified according to the characteristics of movement disorder symptoms rather than etiology
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With the introduction of neuroimaging and genetic testing technology into the field of CP etiological diagnosis, we have found more and more diseases with similar clinical manifestations of CP, but in fact other congenital genetic or metabolic diseases
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Especially in the absence of risk factors for perinatal brain injury and in the absence of typical signs on neuroimaging
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This has caused clinicians to think deeply about the descriptive diagnostic label of CP
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Once relevant warning clues are found, further improvement of hematuria metabolic screening and genetic testing is required to clarify the etiological diagnosis of CP
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Source: "I can still eat a small fish and worm" The etiology of the public account of CP is highly complex, and the development of new technologies has brought opportunities for the accurate diagnosis of CP.
However, the genetic etiology detection of CP is in the early stage of development, and it needs to be based on clinical manifestations.
The pathogenicity and mechanism of genetic variation in the pathogenesis of cerebral palsy need to be carefully judged, further functional verification or research confirms, and the interpretation of genetic test results must be combined with comprehensive analysis of clinical data
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On the other hand, a more detailed etiological assessment aims at early identification of treatable genetic or metabolic disorders
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It is not intended to overturn the classic concept and classification of CP utility based on history, symptoms/signs
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"Expert Consensus on Etiological Diagnosis Strategies of Cerebral Palsy" to formulate a flowchart of the etiological diagnosis of cerebral palsy.
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