Page 27 - Handbook of Electronic Assistive Technology

14 HANDBOOK OF ELECTRONIC ASSISTIVE TECHNOLOGY

Messages go into and out of the spinal cord via cable-like bundles of nerve fibres, some
with and some without myelin sheaths – these are called peripheral nerves, which are
clearly linked out to muscles and organs via the involuntary autonomic system, or in from
end sense organs. These include gross and fine touch, position (proprioception), vibra-
tion, temperature and a variety of different pains.
In the head there are specific cranial nerves that deal with the motor and sensory man-
agement of the head and neck. These include the special senses of vision, hearing, bal-
ance, taste and smell.
That’s quite enough of all that. Except to say that all neurology is useless without a body
to manage and interact with. Normal biomechanics, joints, muscles, levers and forces and
the wide variety of ways we learn and interact with our environment and others make it
all worthwhile.

When Things Don’t Work

Any neurological disease state is based on static or progressive impairment of the macro-
and microanatomy and/or physiology. Disordered systems lead to clinical and functional
problems, requiring a team approach to minimise the challenges for the individual.
In the medical mind we work in a system or sieve when trying to work out why any
health problem occurs.

Specific Conditions

Cerebral Palsy
Overall prevalence is around 2.6/1000 live births. The most up-to-date definition of cerebral
palsy (CP) was outlined by the American Academy of Cerebral Palsy and Developmental
Medicine (Bax et al., 2005): ‘(It) describes a group of disorders of the development of
movement and posture, causing activity limitation that is attributed to non-progressive
disturbances that occurred in the developing foetal or infant brain. The motor disorders of
cerebral palsy are often accompanied by disturbances of sensation, cognition, communi-
cation, perception, and/or behaviour, and/or by a seizure disorder.’
There are a number of independent risk factors for the development of CP. Risk factors
and causes have been summarised in the recent NICE Guidelines (2017).
Antenatal:

• Preterm birth – increasing risk the earlier the delivery.
• Chorioamnionitis – infection of the womb lining.

Perinatal:
• Low birth weight.
• Maternal infection especially chorioamnionitis.
• Neonatal encephalopathy especially hypoxic/ischaemic.
• Neonatal infection.