Pathophysiology Cerebral Palsy

1. Pathophysiology Cerebral Palsy It happenedCerebral Palsydue to damage to the motor center which causes movement disorders, in general, it is thought to involve disruption of oxygen supply to the fetus or brain asphyxia. This causes cell death and loss of cellular processes in response to proinflammatory cytokines, oxidative stress, and excessive glutamate release, then triggering an excitotoxic cascade.Several factors that can influence the disruption of oxygen supply to the fetus include: a. Intrauterine factors: intrauterine grouw restriction (UGR), placental vascular disorders, intrauterine infections, and congenital abnormalities b. Peripartum asphyxia events: placental abruption, chorioamnionitis, and c. Incidentnintraventricular, periventricular leukomalacia, neonatal stroke sepsis.in period neonates: bleeding In congenital disorders, the cause is rarely identifiedCerebral Palsy, in most cases involves environmental factors and genetic susceptibility and can be very severe. This disorder often occurs in the brain which is still very immature so it can cause obstacles to further development. 6. Clinical Symptoms The criteria for clinical symptoms according to Bax are as follows: a. There is a characteristic depression/asymmetry of primitive reflexes such as the Moro reflex, suscking reflex, rooting reflex, tonic neck reflex, palmar and stepping reflex in the neonatal period. b. There is a delay in the development of gross motor skills such as rolling over, sitting or walking. At the age of more than 1 year c. The presence of spastic, plexid and mixed paralysis in cerebral palsy types hemiplegia, quadriplegia, diplegia, monoplegia and triplegia. d. There are involuntary movements in spasticity that are flaccid, rigid, or mixed. Such as tremor movements, choreoathetosis and athetos e. There is a coordination disorder in ataxia which is caused by damage to the cerebellum where hypotonia occurs, and delays in motor development such as walking very slowly, making movements awkward. f. The absence of several reflexes such as the landau and parachute reflexes and the persistence of primitive reflexes g. There are also visual strabismus, or refractive disorders disturbances (for example: hemianopsia, errors), speech disorders, sensibility h. The Asymmetrical Tonic Neck Reflex and Moro Reflex still appear which should have disappeared by the age of 6 months i. When the child is on his back, the hip position is too adducted and rotated so that scissoring movements occur in the legs j. When the child is sitting, the child sits on the sacrum with the legs in a scissor position where the position is adduction, endorotation, plantar flexion. k. In Cp Spatik Quadriplegia there is patron flexion and no rotation when the child rolls over and sits up. 7. Signs in conjunctions The presence of signs of severe motor disorders in the later stages of life include: a. Difficulty eating and communicating This eating and communication disorder is an early, persistent symptom that can result in difficulty expressing language in the future and affect the child's cognitive development. This is possibly due to excessive drooling in children aged 34 weeks or more and experiencing impaired bulbar function. poor, recurrent aspiration pneumonia and failure of lung growth b. Hypotonia, motor stereotypes and postural abnormalities Severe hypotonia is an important early sign of neurological damage. Babies who experience weakness (floppy) can develop dystonia or dyskinesia until the end of the first year of life c. Seizures Seizures in infants and neonates Spasms and convulsions in babies influence the occurrenceCerebral Palsyby 20%, although brain structure injury increases, especially in cerebral quadriplegia and hemiplegia accompanied by pre-existing cortical disorders, but seizures rarely occur in children withCerebral Palsydiplegia. d. Vision OnCerebral Palsyalso experience vision problems, especially retinal detachment in retinopathy such as squint and accompanied by developmental delays. e. Hearing Cerebral PalsyComplications of microcephaly, microphthalmia and congenital heart disease should be examined for Toxoplasma, Rubella, cytomegalovirus, kernicterus (TORCH) which can cause sensorineural deafness at high frequencies. f. Cognitive function and behavior In sufferersCerebral Palsyalso shows function and behavioral disorders. signs of impaired cognitive