A. Causes

• Brain Damage: Non-progressive injury to the developing brain (prenatal, perinatal, or postnatal).
• Hypoxia: Lack of oxygen during birth or early development.
• Infection: Maternal infections or infections in infancy (e.g., meningitis).
• Prematurity: Increased risk associated with very low birth weight and premature birth.

B. Symptoms

• Spasticity: Increased muscle tone and reflexes, leading to muscle stiffness and difficult movement.
• Dyskinesia: Involuntary, uncontrolled, and sometimes slow or writhing movements.
• Ataxia: Impaired balance and coordination, leading to unsteadiness.
• Postural Abnormalities: Difficulty maintaining upright posture or atypical trunk and limb alignment.
• Functional Limitations: Difficulty with gross motor skills (walking, sitting) and fine motor skills.

C. Diagnosis

• Clinical Picture: Based on delayed motor milestones and persistent, abnormal muscle tone/reflexes.
• Exclusion: Ruling out other progressive neurological disorders.
• Classification: Defining the type (e.g., spastic, dyskinetic) and severity (Gross Motor Function Classification System – GMFCS).
• Imaging: MRI may show evidence of brain injury in specific areas (e.g., periventricular leukomalacia).

D. Physiotherapy Treatment Plan

• Goal: Maximize functional mobility, prevent secondary complications (contractures), and promote participation.
• Spasticity Management: Sustained stretching, positioning, and post-Botox injection therapy.
• Orthotics: Use of AFOs (Ankle Foot Orthoses) to control foot position and aid gait.
• Gait Training: Specialized training using body weight support or posterior walkers to encourage ambulation.
• Strength/Motor Control: Targeted strengthening to balance spasticity and improve selective motor control.
• Contracture Prevention: Regular range of motion exercises and use of standing frames for weight-bearing.
• Family Education: Training caregivers on proper handling, positioning, and home exercise program adherence.