CEREBRAL PALSY- ATAXIA

Most CP Ataxic shows inco-ordination of movement, defective balance reactions, hypotonia or a mixed hypotonia and rigidity. In a number of cases there is a tremor, often an intention tremor. These children are late in all the motor milestones and when they learn to walk, may do so with a wide gait with stiff, rigid legs, often showing hyperextension of the knees. Their hand movements are inco-ordinated and floppy.


Causes

In this ill-defined group of cases there are some, where the condition is inherited as an autosomal recessive, and two or more inco-ordinated children occur in one family. In an occasional family, the condition is dominant and the child has the same neurological abnormality as one of his parents. The motor disability may follow a developmental abnormality. Children who survive a repair of an occipital encephalocoele may show a true cerebellar ataxia, as part or whole of the cerebellum may be involved in the defect. Several of these children have hydrocephalus due to a congenital abnormality, perinatal brain damage or later cerebral infection. An abnormal birth with severe neonatal difficulties appears to be a factor in the causation of ataxia, as in other movement defects. Forms of ataxia have followed various forms of meningitis or viral encephalitis.


Early Identification


Children later found to be ataxic are likely to be delayed in all milestones of childhood except, if intelligent the apparent ability to understand what is said to them. There may be feeding difficulties and late development of speech and of ability to feed them. Walking, when established, may be infantile and unstable. These cases can easily be mistaken for children who will grow up to be severely subnormal mentally. The general inco-ordination masks their potential intelligence.


Associated Factors

Ataxic children may show all the additional defects of other cerebral palsied children -

Speech: All ataxic have a very mild, moderate or severe speech defect.
Due to hypotonia, the movement of respiration, swallowing, chewing, phonation and voice production can be affected.
Hearing: There is a strong likelihood of a partial hearing defect which takes the form of a high frequency loss. 
Visual: A high incidence of hypermetropia and myopia has been noted in Ataxic. All children should have an eye refraction examination early. In coordinated eye movements occur in nearly every child Epilepsy: This occurs frequently in ataxic children. Intelligence: These children generally have poor cognition due to visuoperceptual problem.


Treatment


Prognosis
Due to balance and perceptual problem, these children get problem in working in open market but with supervision they can work in any shelter workshops.


Employment


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