Cerebral palsy (CP) was defined as "a permanent, but not unchanging disorder of movement and posture due to a non-progressive defect or lesion of the brain in early life" by the Little Club in 1964. This definition is not universally agreed but it is still widely used. It may be associated with cognitive, sensory and behavioral manifestations. The prevalence of CP has changed very little over the past 40 years. As a result of improved survival of prematurely born infants with very low birth weight, more individuals have severe motor disability and associated handicaps. The incidence of CP is 2∼5/1,000 live births, but at 7 years of age, the rate is estrmated to be 2/1,000 births. Management of a child with CP requires a multidisciplinary approach shared with the child and family and should support for them. Numerous ways have been tried to moderate the abnormalities found in the different varieties of CP. The aim of treatment is to prevent the development of deformity, suppress unwanted or abnormal movements and promote optimal function. The well-known systems of physical therapy include those of the Bobaths, Vojta and the Peto. Occupational therapy concentrates on eye-hand coordination and upper extremity motor control and other activities of daily life. Orthosis usually is prescribed to correct abnormal posture of the ankle and foot. Topical injection of phenol, alcohol solution or botulinum toxin into the motor points or motor nerves of a spastic muscle creates a temporary neurolysis and consequent tone reduction lasting 5 to 6 months. Currently intrathecal baclofen is widely used. Where contractures have occurred in the hips and knees, soft tissue surgery around the hip, knee and ankle in a simple operation may be carried out. |