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Samenvatting Cerebrale parese en Neuromusculaire aandoening
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CP & NMALouise Vansteenkiste
HOGENT
,1 ONTWIKKELING VAN HET CZS .................................................................................................... 3
1.1 ALGEMENE ONTWIKKELING ........................................................................................................... 3
2 NEUROANATOMIE ..................................................................................................................... 7
2.1 DE HERSENEN ............................................................................................................................ 7
2.1.1 CEREBRUM..................................................................................................................................... 7
2.1.2 THALAMUS..................................................................................................................................... 8
2.1.3 BASALE GANGLIA ............................................................................................................................. 8
2.1.4 HERSENSTAM ................................................................................................................................. 9
2.1.5 CEREBELLUM .................................................................................................................................. 9
3 BASISPRINCIPES VAN DE MOTORISCHE ONTWIKKELING .......................................................... 10
4 PERSONEN MET EEN NEUROMOTORISCHE HANDICAP ............................................................. 11
4.1 NEUROMUSCULAIRE AANDOENINGEN ............................................................................................ 11
4.2 CENTRAAL NEUROLOGISCHE AANDOENINGEN .................................................................................. 11
4.2.1 CEREBRALE PARESE ....................................................................................................................... 11
5 INCIDENTIE, VORMEN EN OORZAKEN VAN HERSENSCHADE .................................................... 13
5.1 INCIDENTIE .............................................................................................................................. 13
5.2 VORMEN VAN HERSENSCHADE ..................................................................................................... 13
5.2.1 PERIVENTRICULARIE LEUCOMALACIE (PLC) ........................................................................................ 13
5.2.2 INTRAVENTRICULAIRE BLOEDING ...................................................................................................... 13
5.2.3 LETSEL IN BASALE KERNEN (BASALE GANGLIA) ..................................................................................... 13
5.2.4 ARTERIËLE INFARCTEN .................................................................................................................... 13
5.3 OORZAKEN VAN HERSENSCHADE. ................................................................................................. 14
5.3.1 PRENATALE OORZAKEN................................................................................................................... 14
5.3.2 PERINATALE OORZAKEN .................................................................................................................. 15
5.3.3 POSTNATALE OORZAKEN ................................................................................................................. 16
5.4 PREMATUUR EN DYSMATUUR ...................................................................................................... 16
5.4.1 PREMATUUR ................................................................................................................................ 16
5.4.2 DYSMATUUR ................................................................................................................................ 16
6 CLASSIFICATIE ......................................................................................................................... 17
6.1 TOPOGRAFISCH ........................................................................................................................ 17
6.2 KLINISCH BEELD ........................................................................................................................ 17
6.2.1 TONUS ........................................................................................................................................ 19
6.3 ERNST .................................................................................................................................... 20
6.4 FUNCTIONALITEITSSCHALEN ........................................................................................................ 20
6.4.1 ICF ............................................................................................................................................. 21
6.4.2 GMFCS (GROSS MOTOR FUNCTION CLASSIFICATION SYSTEM) ............................................................. 21
6.4.3 MACS (MANUAL ABILITY CLASSIFICATION SYSTEM)............................................................................ 22
6.4.4 CFCS (COMMUNICATION FUNCTION CLASSIFICATION SYSTEM) .............................................................. 22
,6.4.5 VSS (VIKING SPEECH SCALE) ........................................................................................................... 22
6.4.6 EDACS (EATING AND DRINKING ABILITY CLASSIFICATION SYSTEM) ........................................................ 23
6.5 PROGNOSE .............................................................................................................................. 23
6.6 OEFENING FUNCTIONALITEITSSCHALEN TER VOORBEREIDING VAN HET EXAMEN....................................... 24
7 NEUROMUSCULAIRE AANDOENING......................................................................................... 27
7.1 ONTWIKKELING VAN PERIFERE ZENUWSTELSEL ................................................................................ 27
7.2 VOORKOMEN........................................................................................................................... 28
7.3 INCIDENTIE .............................................................................................................................. 28
7.4 SYMPTOMEN ........................................................................................................................... 28
8 LOCALISATIE WAAR HET FOUT KAN GAAN ............................................................................... 30
8.1 VOORHOORNCEL AANDOENINGEN ................................................................................................ 30
8.1.1 SMA .......................................................................................................................................... 30
8.1.2 ALS ............................................................................................................................................ 30
8.1.3 POLIO ......................................................................................................................................... 31
8.2 AANDOENINGEN AAN DE ZENUWWORTELS/ PLEXUS ......................................................................... 31
8.2.1 GBS ........................................................................................................................................... 31
8.2.2 NA ............................................................................................................................................. 32
8.3 AANDOENING IN DE PERIFERE ZENUWEN ........................................................................................ 32
8.3.1 CARPAAL TUNNEL SYNDROOM ......................................................................................................... 32
8.4 AANDOENINGEN IN DE MUSCULAIRE OVERGANG .............................................................................. 33
8.4.1 MYASTENIA GRAVIS ....................................................................................................................... 33
8.5 AANDOENING VAN DE SPIER ........................................................................................................ 33
8.5.1 SPIERZIEKTE VAN DUCHENNE (= GENETISCH BEPAALDE SPIERDYSTROFIE OF MYOPATHIE) ............................ 33
8.5.2 ZIEKTE VAN STEINERT ..................................................................................................................... 34
, Cerebrale Parese
1 Ontwikkeling van het CZS
Cerebrale parese
= letsel in hersenen waardoor er een stukje van de hersenen uitvalt. Ze zijn daardoor niet in
staat om via de zenuwen de juiste spanning aan de spieren door te geven waardoor die niet
samen kunnen werken met elkaar. Dit zorgt voor motorische stoornissen.
1.1 Algemene ontwikkeling
Hoe kind ontwikkelt vanaf bevruchting. Belangrijk als referentiepunt om afwijkingen te
begrijpen.
CZS ontwikkelt zich al vanaf drie weken na bevruchting en is langst in ontwikkeling en langst
kwetsbaar.
0 tot 4 -5 weken
Embryo ontstaat uit platte schijf met drie lagen cellen
- endoderm: interne organen (viscera)
- Mesoderm: skelet en spieren
- Ectoderm: zenuwstelsel en huid
(= Eerst neurale plaat)
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