Paediatric-History taking and physical examination of cerebral palsy

Paediatric-History taking and physical examination of cerebral palsyCreated OnApril 21, 2020Last Updated OnApril 21, 2020byadmin You are here: Main Clinical Examination Paediatric-History taking and physical examination of cerebral palsy < All Topics Table of Contents History taking: Ask about patient’s details: name, age, gender Ask about history of presenting illness Is the child mobile? If so, how does he/she get around? – crawl, cruise, walker, manual wheelchair, power wheelchair? If muscle tone, movement affected – which side (R/L), upper/ lower extremity is affected more? Or equally affected? Any involuntary twisting movements (dystonia) Any rapid, jerky movements (chorea) Do the symptoms progressively worsen? – in CP it is non-progressive How does the child communicate? – words, eye gaze, crying, pointing, assistive device? Ask about antenatal history Parental consanguinity? Gestational age at delivery Intrauterine growth restriction (IUGR) Intrauterine infection (TORCHES) Antepartum haemorrhage Placental pathology Antenatal screening for genetic disorders/ congenital malformation Maternal seizure disorders Maternal diabetes mellitus/hypertensive disorders History of miscarriages/stillbirths? Maternal intake of drug/alcohol Ask about birth history Mode of delivery? Birth weight? – low birth weight has increased risk of CP Difficult delivery? – asphyxia or trauma during labour Oxytocin augmentation Breech presentation Problems after birth Cord around neck? Jaundice? Breathing problems? Difficulty feeding? Ask about past medical history Episodes of hypoxic ischemic encephalopathy Meconium aspiration Infections: encephalitis, meningitis Traumatic brain injury Seizure disorder Severe asthma/ pneumonia Ask about developmental history Developmental delay – if the child has siblings, compare the developmental milestones with siblings (eg. The child started walking later than siblings) Ask about feeding history How does the child feed? – by mouth? NG tube? If on formula milk – name, amount (ounces), frequency Solid food intake? Feeding difficulties? – choke/ gag, cough, vomit, refuse feeding Ask about family history Any family hx of cerebral palsy, seizure/ epilepsy, neurological disorder, autism spectrum disorder Hx of genetic disorders, growth problem, intellectual disability Hx of chronic illness such as HT, DM, heart disease, kidney disease Ask about immunization history Are immunizations up to date? Ask about drug history Any allergies to drug or food? Ask about social history Where is the child staying? Who is the child staying with? Financial status of parents/ carer Physical examination: Vital signs: blood pressure, Pulse, Respiratory rate, spO2, Temperature Nearby equipment: crutches, wheelchair, nasogastric (NG) tube...

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