Core manifestations of children with cerebral palsy

  Developmental neurological abnormalities in cerebral palsy are characteristic and core elements of cerebral palsy.  1. Central motor dysfunction: It is mainly manifested in several aspects of gross and fine motor functions as well as postural motor patterns.  (1) All children with cerebral palsy cannot follow the normal pattern of motor development and reach the level of motor development of children of the same age.  (2) Fixed motor patterns may appear: for example, the whole body flexion pattern and whole body extension pattern in spastic cerebral palsy, and the coracoacromial pattern in non-random movement cerebral palsy.  (3) Asymmetric postural movement patterns: such as ATNR posture in non-random motion cerebral palsy, shortening pattern of trunk on one side in spastic hemiplegia, etc.  (4) Anti-gravity motor difficulties: such as hip-high head-low in prone position, inability to raise the head or difficulty in raising the head, inability of both upper limbs to support the trunk, shoulder on the bed; inability to switch from low to high posture, etc.  (5) Difficulty in detachment movement: such as inversion, internal rotation, flexion of both upper limbs, clenching of fists in both hands; straightening or inversion of both lower limbs in a “scissor step”; “rabbit jump” when crawling; shortening of stride length when walking, etc.  (6) The presence of abnormal sensorimotor: such as easily startled and trembling in response to external stimuli; aversion to touching certain objects, etc.  (7) Persistence of joint reactions and compensatory movements: for example, when grasping an object with one hand, the other hand makes a fist with force, and the whole body is tense with open mouth, etc.  (8) Balance coordination disorder and ataxia: e.g. unstable walking, wide base, slow turning, inability to walk in a straight line, inability to stand on one leg, negative finger-nose test in ataxic cerebral palsy, etc.  (9) Irregular movement patterns: such as tardive movements and dance-like movements that are difficult to control by will.  (10) Extreme “floppy” pattern: such as “frog-like” posture in supine position, “folded” posture in sitting position, “inverted U” posture in prone position in the early stage of non-random motion cerebral palsy. The posture of “inverted U”, etc.  2. Abnormal muscle tone and muscle strength: the symptoms include increased muscle tone, decreased muscle tone, changes in muscle tone or imbalance, and changes in muscle strength.  (1) Learn about muscle tone through passive movement, flexion, extension, rotation of the front and back of the limb. Small infants can hold their forearms and shake their hands and hold their lower legs and shake their feet to determine muscle tone by observing the range of motion of the hands and feet.  (1) It can also be judged by the range of motion of joints. A large range of motion of joints indicates low muscle tone and vice versa.  (2) Spastic cerebral palsy has increased muscle tone, which is expressed as “folding knife sign”.  (3) In the early stage of non-random movement cerebral palsy, muscle tone does not increase or is low, but increases with age.  (4) Ankylosing cerebral palsy (currently classified as non-random movement type in China) shows “lead pipe” or “gear-like” increased muscle tone.  (5) The ataxic cerebral palsy muscle tone is not increased or may be decreased.  (6) Hypotonia cerebral palsy (currently abolished in China) is characterized by hypotonia in the early stage, but the muscle tone may change in the later stage.  (7) Most children with cerebral palsy have insufficient core muscle strength and poor resistance to gravity and postural transition.  (8) The effective motor function is reduced due to insufficient muscle strength of antagonist muscles or both active and antagonist muscles.  All children with cerebral palsy have abnormal reflex development, and the main manifestations are as follows: the main manifestations are hyperactive or delayed disappearance of primitive reflexes. The presence of the standing uprightness (correction) response and balance response (tilt response) was delayed or incompetent.