Cerebral Palsy and the NICU Graduate

Abstract

PUT YOURSELF IN THIS SITUAtion. You have three drips to remix, your oscillator patient is starting to crash, and you have just been asked to work a double shift because the hospital is short staffed. The unit secretary informs you that the mother of one of your former primary patients is on the telephone and is hysterical. A physician at the neonatal follow-up clinic has just told her that her baby has cerebral palsy (CP). She wants reassurance, information, and input from you because you established a rapport with her when her infant was in the neonatal intensive care unit and she trusts you. You remember cerebral palsy from your pediatric rotation in nursing school, but you don’t see many actual diagnoses made in the NICU, and your recollection is foggy.

Cerebral Palsy: Comprehensive Review and Update

“…Serial developmental evaluations may be necessary in the young child for proper diagnosis and follow up. 32 , 33 Perinatal complications such as prematurity, head injury, kernicterus, and meningitis are important risk factors for CP. On the other hand, a family history of neurological disorders and early or unexplained deaths indicates an undiagnosed inherited neurodegenerative disorder.…”

“… 35 Early warning signs of CP include developmental delay, toe walking, persistent fisting, microcephaly, epilepsy, irritability, poor sucking, handedness before 2 years of age (indicating hemiparesis), and scissoring of the lower limbs. 33 In addition, persistence of primitive reflexes can be an early indicator. A multidisciplinary evaluation is recommended and may necessitate input from physiotherapy, occupational therapy, ophthalmology, audiology, orthopedics, radiology, neurology, genetics, developmental pediatrics, and social services.…”