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Cerebral Palsy (2nd Ed., 2nd ed. 2019)

Langue : Anglais

Coordonnateurs : Miller Freeman, Bachrach Steven, Lennon Nancy, O'Neil Margaret

Couverture de l’ouvrage Cerebral Palsy

Dr. Miller?s valuable resource helps members of the medical team navigate the complexity of cerebral palsy care by explaining unfamiliar treatments that fall outside of their own disciplines.

Readers also benefit from a review of current practices in their own fields.

Includes recommended treatment algorithms and is designed to help improve decision making.

Written in a very conversational style and illustrated with lots of color the volume provides rehabilitational (part 1) and surgical aspects (part 2).

Accomplished by a CD-ROM which provides lots of case studies - including walking analysis.

The most comprehensive title on this topic written by a leading expert.

Section 1  Etiology


The Child, The Parent and the Goal


Congenital malformation


Congenital Metabolic

In utero Stroke

Problem during delivery

Post natal encephalopathy


Section 2 Epidemiology


Over-view of the past 50 Years

American experience

European Experience

Asian experience

African experience


Section 3 Pathology


Physical pathology

Current Imaging -PET

Muscle changes at the cellular level

Gross Anatomic Muscle changes in CP

Neuro-motor junction changes

Bone Alterations in CP


Section 4 Diagnosis


Over view of when and how to evaluate

Who should get Imaging

Indications for metabolic work up

Indications for full genetic work up

Prognosis assessment - role of PE -Pathologic Reflexes

Classification Terminology


Section 5 General Medical Concerns


Over view of Normal Natural history

The Irritable Child with CP

Pain in The Non-communicative Patient

Post-operative Pain Management


Section 6 Neurologic Problems


Seizures - Diagnosis, Natural History

Seizures - Medical Management

Seizures - Ketogenic Diet - Indication and Description

Seizures - Role of VNS

Seizures - Role of Surgical Removal

Seizure Surgery - Workup and technique Description

Pseudo-seizures - Diagnosis and Treatment

Hydrocephalus Diagnosis and treatment indications

Shunting for Hydrocephalus

Surgical Ventriculostomy for Hydrocephalus


Section 7 Psychologic and Psychiatric Problems


Attention Deficient associated with CP

Autism and CP as Comorbidities

Family Stress Secondary to Disability

Impact on Siblings

Depression associated with CP

Mood disorders (Bipolar and CP)

Thought disorder and CP


Section 8 Gastro-intestinal Problems


Over view and natural of feeding issues with growth and development

Aspiration - risks, work up, when is it a problem

Gastrostomy feeding - when indicated

Tracheostomy or diversion - When indicated and how done

Weight and growth in the child with CP

Feeding Therapy - Indications how long (Maybe in therapy section)

GE reflux - Work up and medical Management

GE Reflux - Work up and Surgical Management

Poor Intestinal Motility

Constipation - Implications long term and treatment


Section 9 Genito-Urinary


Toilet training and bladder control - Expectations and when to work up

Neurogenic Bladder

Renal stones - risks, prevention and management

Undescended Testicles -


Section 10 Ear Nose and Throat


Drooling - diagnosis, measurement and medical management

Drooling - management with local injections - Botulinum

Drooling - Surgical treatment options and outcomes

Hearing Evaluation - When and How

Cochlear Implant Indication and role in CP

Upper Airway Obstruction - Indication for adenoid and tonsillectomy


Section 11 Pulmonary


Bronchopulmonary Dysplasia - Natural History, etiology and outcome

Bronchopulmonary Dysplasia - Medical management

Reactive airways - Chronic aspiration

Airway obstruction - Work up and medical management

Airway obstruction - Indication and options for surgical management


Section 12 Endocrine


Pitutary-hypohoseal dysfunction

Adrenal insufficency

Short Stature - Work up and treatment indications

Pillow angel treatment - indication ethics approach

Glucose intolerance due to intramuscular fat

Premature or Delayed Sexual Maturation


Section 13 Eyes


Testing Sight - how when and the outcome


Cortical blindness


Section 14 Dental


Routine hygiene, When and how for child with CP

Dental Caries - When to treat, how often to check outcome

Gum Hypertrophy - etiology, and management and outcome

Malignments - when to treat and expected outcome

Bruxism - Management and long term outcome

Lip biting - Management and long term outcome


Section 15 Neuromuscular Function


Neurologic Control of the Muscluosketal System

Muscle tone - Spasticity - Assessment

Movement disorders - Description and assessment

Medical Management of Spasticity

Medical Management of Movement disorders

Local treatment - Botulinum, Phenol, Neurectomy

Inthrathecal Baclofen Therapy

Dorsal Rhizotomy

Deep Brain Stimulation

Ataxia - Disorder of Balance, Description and Assessment

Assessing dynamic Balance


Section 16 Gait in CP


Normal Gait

Overview and Natural history of CP Gait

Use of Diagnostic Gait Analysis to Guide Treatment

Using Gait Analysis as an Outcome Assessment

Managing Hemiplegic Gait

Diplegic Gait

Torsional Malignments

Stance phase - Crouch and Back Kneeing

Swing Phase - Toe drag

Gait with Movement Disorders

Gait in Ataxia

Complications of Gait Management and Gait Analysis


Section 17 Upper Extremity

Overview of Natural History and Outcome

Assessment of the Upper Extremity for Diagnostic Assessment

Assessment of the Upper Extremity for Outcome Evaluation

Tone Management - Botulinum, Neurectomy, Rhizotomy

Single Event Multi-level Surgery Approach



Forearm and Wrist




Section 18 Spine


Overview and Natural History

Non-operative Management of CP scoliosis

Surgical Planning - Medical Evaluation Pre-op

Role and Response to Spinal Cord Monitoring

Anesthesia for CP Spinal Fusion

Surgical Management of Scoliosis (operative Procedure)

Surgical Management of Kyphosis and Lordosis

Post-operative Management

Managing Early Onset Scoliosis in CP

Managing Complications related to Spinal Fusion

Cervical Spinal Problems in CP

Lumbar Spondolethesis

Ambulatory child CP and Scoliosis

Scoliosis and Hip dislocation - Management considerations


Section 19 Hip


Summary Overview

Etiology and Natural History

Screening and Surveillance

Prophalactic Treatment

Reconstruction of Common Posterior Lateral Displacement

Reconstruction of the Atypical- Anterior or Inferior Displacement

Palliative or Salvage Treatment

Complications of CP hip Management


Section 20 Knee


Summary of Knee problems

Patella-femoral instability

Apophositis and stress fractures

Rotatory or torsion Instability

Fixed knee flexion Contracture

Hyper-extension knee deformity

Knee extension Contracture and Stiff Knee Gait

Tibial Torsion and Bowing


Section 21 Ankle, Foot, and Toes


Over view of the FOOT in CP

Natural History of Foot posture in Children with CP


Ankle Varus and Valgus





Claw toes, Over Lap, and Crossing Toes

Toe Nail Problems

Complications of Managing Foot Problems


Section 22 Physical Therapy


Over view and history of therapy for CP

Early Intervention - techniques and outcome

Habilation therapy - in middle childhood - role and outcome

Short High Intensity VS Long-term Low frequency

Rehabilitation Therapy -(Post op) Frequency and Approach

Role of Therapy in Teenagers to prevent function loss

Educational Therapy - Technique outcome, how not medical therapy

Therapy Theories - NDT ECT outcome expectations


Strength Training

Cardiovascular Endurance training


Robotic training, Suspended Treadmill training


Section 23 Occupational Therapy


Over view theories and expectations

Early intervention expectations and outcome

UE Habilation techniques - Outcomes

Constrained use - Enforced use Therapy Techniques and expected outcome

UE splinting VS use encouragement

Evaluation for Driver Training and adaptations


Section 24 Speech Therapy


Over view of ST and expect outcome

Feeding Therapy Indications, techniques, outcome

Speech therapy, When techniques and expected outcome.

Augmentative communication, When and expected outcome how to evaluate

Training oral control for Drooling - Techniques and outcome


Section 25 Augmentative and Complimentary Therapies


Over view of the wide range

Swimming with Dolphins

Hyperbaric Oxygen


Pressure suits and vests

Elastic Space suits

Votja Technique



Section 26 Durable Medical Equipment


Standers - Which, when how long, who and what is the benefit

Reclining - Side Lyers, wedges, beds - Benefit for who and when

Gait trainers - Who when how long - Benefit

Walkers - WHO WHEN how long and what is the benefit

Crutches, and canes and sticks -

UE - Self feeders - WHO W WH outcome


Section 27 Wheel Chairs


General Over view of issues to be considered

Wheel chair VS stroller - difference and why and when and outcome

Power Wheel chair - WHEN WHO outcome

Early power wheeled toy mobility - Benefit outcome

Consideration of the appropriate WHEEL chair for permanent use

One arm drive chair for who and when


Section 28 Orthotics


General Overview when indicated benefits and risks

Control Foot posture - Arch supports, UCBL and SMO

Ankle control

Knee control options

Hip control

UE orthotics

Freeman Miller, MD

Co-Director Cerebral Palsy Program

AI DuPont Hospital for Children

Wilmington, DE 


Steven Bachrach, MD

Co-Director Cerebral Palsy Program

AI DuPont Hospital for Children

Wilmington, DE


Nancy Lennon, PT

Cerebral Palsy Program Manager

AI DuPont Hospital for Children

Wilmington, DE 


Margaret O’Neil, PT, PhD, MPH

Associate Professor

Drexel University

Philadelphia PA

Dr. Freeman Miller is a pediatric orthopedic surgeon with special expertise in neuro-orthopedics. He’s past president of North American Society of Gait & Clinical Movement Analysis; past editor-in-chief, Gait and Posture; guest lecturer at hundreds of national and international events; and author of 145 articles in peer-reviewed journals.

Comprehensive resource to Cerebral Palsy (CP)

Covers the pathology and impact of CP on the musculoskeletal system and the latest research and patient management techniques

New edition features expanded sections on the medical management of children with CP, research and therapies

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