337 Slov Pediatr 2018; 25
THE DEGREE OF ACHIEVED DEVELOPMENT IN A CHILD WITH 
CEREBRAL PALSY – A CASE REPORT
N. 	 T adić,	 V 	 Ivančević,	 D.	Hadžić
Health Care Center, Budva, Montenegro
ABSTRACT
Introduction: 	 Cerebral 	 palsy 	 is 	 a	 group 	 of	 permanet	 disorders	 which	 affect 	 the	 movements 	 and 	 therefore	
cause	 limited 	 motion	 in 	 a 	 person.	 The 	 term	 “cerebral”	 refers	 to 	 the 	 brain, 	 and 	 “palsy” 	 to 	 the	 disorder	
(or 	impairment) 	of	movement.
Case Report:	 W e	 present 	 a 	 four -year -old	 boy 	 who 	 was 	 diagnosed	 with	 cerebral 	 palsy 	 at	 the 	 early 	 stage 	 of	
his 	 life. 	 This 	 was 	 his 	 mother ’ s 	 second, 	 uncomplicated	 pregancy . 	 The 	 boy	 was	 deliviered 	 spontaneously 	 on 	
due 	 date 	 with 	 the 	 umbilical	 cord 	 wrapped 	 once	 around	 his 	 neck. 	 After	 the 	 delivery , 	 the 	 boy 	 was 	 not 	 breath -
ing, 	 was	 bradycardic 	 and 	 in 	 an 	 altered	 state 	 of 	 consciousness. 	 He	 has 	 had 	 to 	 be 	 intubated 	 and	 transferred	
to	 the 	 Center 	 of	 Neonatology 	 in 	 Podgorica. 	 From 	 the 	 records 	 we 	 got 	 the	 following 	 information: 	 in 	 the 	 first 	
hour 	 of 	 his 	 life 	 he 	 was 	 in	 an 	 altered 	 state 	 of	 consciousness, 	 without 	 any 	 spontaneous 	 breathing, 	 intubated, 	
bradycardic, 	 in	 an 	 extension 	 posture	 and 	 with 	 no 	 movements 	 or 	 neonatal	 reflexes. 	 The	 laboratory	 results	
indicated 	 metabolic-respiratory	 acidosis.	 Ultrasound 	 (US) 	 of 	 the	 brain 	 revealed	 intracranial 	 haemorrhage ,	
which 	 was 	 confirmedon 	 the 	 computed 	 tomography 	 (CT) 	 of 	 the	 brain.Hearing 	 and 	 ophthalmological	 screen -
ing 	 were 	 normal. 	 During 	 the 	 first 	 four	 days	 of	 his	 life, 	 the	 boy 	 has 	 had 	 several 	 convulsive 	 attacks, 	 however 	
the 	 EEG 	 revelaed 	 no 	 epileptic 	 bursts.The 	 antimicrobial,	 antiedematous	 and 	 anticonvulsive 	 treatments	 were 	
started 	 for 	 the 	 next 	 12 	 days 	 and 	 withdrawn 	 thereafter .	 later . 	 The 	 baby	 was	 dichar ged 	 from	 	 hospital 	 and 	
the 	 age	 of 	 	 2 	 months, 	 and 	 recommended 	 to 	 continue 	 on	 	 Phenobarbiton	 and 	 regular 	 and	 continous 	 physical 	
treatment. 	 One 	 month 	 later 	 the 	 neurological 	 examination 	 showed:	 the 	 A TNR	 was 	 present	 to	 the 	 right, 	 with 	
hands 	 in 	 flexion 	 and	 abduction, 	 with 	 cortical	 thumbs, 	 and 	 with 	 legs 	 floppy . 	 He	 was 	 able 	 to 	 make	 noises, 	
could 	 hold	 items 	 placed	 into 	 his 	 hands, 	 but 	 has 	 had 	 trouble 	 lifting 	 his 	 head 	 when	 lying 	 prone, 	 and 	 the	 trac -
tion 	 of	 the 	 head	 cused 	 backward 	 tilt. 	 At 	 the 	 age 	 of	 12	 months, 	 his	 fists 	 were 	 still 	 partially	 closed, 	 with 	 corti -
cal 	 thumbs, 	 was 	 able 	 to 	 lift 	 his	 head 	 up 	 to	 4 	 degrees 	 when 	 lying 	 prone. 	 The	 tone 	 of	 the 	 upper 	 extremities 	
was 	 less 	 increased, 	 he 	 was 	 able 	 to 	 follow 	 movement 	 with 	 his 	 eyes 	 and 	 able 	 to 	 fix 	 the 	 objects. 	 When 	 lying 	
supine, 	 A TNR	 dominated 	 on 	 both 	 sides. 	 At 	 the 	 age 	 of 	 36 	 month 	 she 	 was 	 able 	 to 	 follow 	 movements 	 and 	
objects 	 around 	 him, 	 and 	 the 	 muscle 	 tone 	 was 	 reduced. 	 At 	 the 	 age 	 of 	 42 	 months 	 he 	 followed 	 his 	 father 	 with 	
his 	gaze,	 reacted 	to	sound,	 lifted 	 his 	 head 	and 	could	keep	 it	in	this	position	for	about 	2	 minutes.
Conclusion: 	 For 	 every 	 child 	 suffering 	 from 	 cerebral 	 palsy 	 it 	 is 	 vital 	 to 	 create 	 a 	 unique 	 and 	 or ganized	 pro -
gram 	 for 	 their 	 development. 	 Encouraged 	 and 	 loved 	 children	 with 	 cerebral	 palsy 	 can 	 achieve 	 a 	 lot 	 more 	 than 	
what 	 one 	 would 	 expect 	 from 	 them, 	 considering 	 their 	 handicap. 	 A 	 good 	 collaboration 	 of 	 the 	 whole 	 team 	 of 	
the 	patient,	 the 	patient	 himself 	 and	family 	 is	needed 	for	good	 success 	 and 	outcome.
Key words: cerebral palsy, child, development.