User:Bonnerry/Athetoid cerebral palsy

Athetoid/ Dyskinetic Cerebral Palsy (ADCP) is a brain disease that makes up approximately 10-15% of all cerebral palsy cases. Unlike spastic or ataxic cerebral palsies, athetoid cerebral palsy is characterized by both hypertonia and hypotonia.

Group Members: Brian Byrne, Ryan Bonner, James Murphy

Our group will meet weekly at the minimum to discuss the progress each of us has made in developing this stub. We will split up the work by topic, allowing each of us to become experts in a certain area and ensuring that we cover each topic in depth. However, each group member is expected to look over the article as a whole and to review topics that are not their own for completeness, accuracy, and grammar/language.

Classification
In both research and the clinic, cerebral palsy is is classified according to the nature of the movement disorder and the anatomic, topographic distribution of motor abnormalities.

Signs & Symptoms
Athetoid Cerebral Palsy is characterized by uncontrollable muscle tone fluctuations, alternating between loose and tense states. This often results in difficulties maintaining posture. Small, rapid, random and repetitive uncontrolled movements known as choreic movements can occur. Difficulties in speech often occur due to difficulties involved with controlling the tongue, breathing, and vocal cords. In addition, eating may be difficult as well, requiring assistance.

Causes/ Etiology
This section will discuss the causes/ etiologies of athetoid cerebral palsy. Athetoid cerebral palsy has been associated with various neuropathies and genetic factors. Athetoid cerebral palsy is most commonly associated with extrapyramidal primary lesions in the Basal ganglia or cerebellum of the brain. These lesions principally arise via hypoxic ischemic brain injury or bilirubin encephalopathy. Other known causes originate from the antenatal, perinatal, and post-neonatal periods of development. Risk factors, such as preterm birth, for ADCP will also be discussed in this section. The role of the obstetrician in ADCP and corresponding litigation events will be discussed.

Genetic Factors
Although genetic factors play a lesser role in the development of ADCP, a risk of recurrence in siblings is suggested. Familial cases of ADCP can be explained by either an autosomal-recessive or X-linked-recessive inheritance.

Diagnosis
Diagnosis of athetoid cerebral palsy is based upon clinical assessment and typically diagnosed by the time a child reaches 18 months old. In clinical practice, diagnosis is primarily based upon observations or parents reports of attained motor milestones. The Gross Motor Function Classification System (GMFCS) as well as the International Classification of Impairments, Disabilities and Handicap (ICID) is widely used in these observations. Neuroimaging testing is also used to confirm the diagnosis. Developmental delays, such as failure to sit up, reach for toys, crawl, stand, or walk at the expected ages may be warning signs for cerebral palsy including ADCP.

Neuroimaging
This section will discuss neuroimaging methods used in diagnosis of Athetoid Cerebral Palsy and pros/ cons of these approaches. Neonatal cranial ultrasound is typically used in nueroimaging of preterm infants. Magnetic resonance imaging (MRI) is also used to determine if a brain abnormality is present in children with neurological findings suggestive of Athetoid Cerebral Palsy.

Treatment
Currently, there is no cure for cerebral palsy. Treatment includes exercise rehabilitation and medication for management of spasticity. This section will discuss various treatments, exercise therapies and medical interventions used for Athetoid Cerebral Palsy. Effectiveness of each therapy will be discussed.

Medical
Medications that impede the release of excitatory neurotransmitters have been used to control or prevent spasms. Surgery can be used to correct or prevent any limb deformities. This section will contain a list of medications used for ADCP, a brief description of each medicine, and the relative effectiveness of the drug in ADCP treatment.

Physical Therapy
Speech and strength therapy can be used to improve communication and motor skills. Various exercise therapies and their therapeutic effectiveness will be discussed.

Prognosis
Studies suggest a poor prognosis for patients with Athetoid Cerebral Palsy. Mortality is strongly associated with both the level of functional impairments as well as associated non-motor impairments. IQ and employment status are also dependent on level of functional impairments. This section will also discuss the strongest/ weakest predictors of athetoid cerebral palsy pathogenesis.

Epidemiology
Cerebral palsy occurs at a rate of approximately 2/1,000 births, and that of the athetoid type comprises about 11-15% of cerebral palsy cases. However, approximations vary based on diagnostic techniques. Regional and global epidemiology as well as diagnostic techniques will be discussed in this section.

History
This section will discuss how Athetoid Cerebral Palsy was discovered and other developments that occurred which furthered our understanding of the disease today.

Society and Culture
This section will discuss how Athetoid Cerebral Palsy appears in society including but not limited to its economic impact, appearances in media like T.V. and film, and notable cases.