1. Cerebral Palsy

2. A group of disorders of the development of movement and posture causing activity limitations that are attributed to non- progressive disturbances that occurred in the developing fetal or infant brain. The motor disorders of cerebral palsy are often accompanied by disturbances of sensation, cognition, communication, perception, and/or behavior and/or a seizure disorder.

3. Brain lesions of CP occur from the fetal or neonatal period to up to age 3 years The etiology of CP is not well understood, and brain lesions are thought to be associated with prenatal, perinatal, or postnatal events of varying causes.

4. Risk factors for CP are multifactorial. Birth, multiple gestation, intrauterine growth restriction, male sex, low Apgar scores, intrauterine infections, maternal thyroid abnormalities, prenatal strokes, birth asphyxia, maternal methyl mercury exposure, and maternal iodine deficiency

5. In developed countries, CP prevalance is about 2-2.5 cases per 1000 live births. In developing countries, it is about 1.5- 5.6 cases per 1000 live births.

6. Typical Types of CP Spastic hemiplegia - CP predominantly affecting one side of the body, with upper extremity spasticity more than lower extremity spasticity (eg, right side involved with right arm more so than right leg) Spastic diplegia - CP affecting bilateral lower extremities more than upper extremities

7. Spastic quadriplegia - CP affecting all 4 extremities (full body) Dyskinetic CP (athetoid CP, choreoathetoid CP, and dystonic CP) - CP with extrapyramidal signs characterized by abnormal movements; hypertonicity often is associated

8. Mixed CP - CP with no single specific tonal quality predominating; typically characterized by a mixture of spastic and dyskinetic components Hypotonic CP - CP with truncal and extremity hypotonia with hyperreflexia and persistent primitive reflexes; thought to be rare