Cerebral palsy types

Cerebral palsy describes a group of disorders that affect posture and body movement. There are different types of cerebral palsy that affect different sides of the body.

Spastic cerebral palsy

This leads to difficulty with moving the child’s joints—the faster the child tries to move, the more the muscle fights. The muscle tone is increased in some of the muscles (hamstrings and calf muscles are commonly affected), while others are too weak to fight that tone.
Most treatment regimens are focused on treating spastic cerebral palsy. Treatment involves loosening the tight muscles using physical and occupational therapy, braces, medication and when necessary, surgery. Spastic cerebral palsy is fairly predictable in its response to all types of intervention

Dyskinetic Cerebral Palsy

The word dyskinesia means there is a problem with motion; but in this case, it is not spastic. There are two types of motion problems: ataxia and athetosis.

  • Ataxia is random movement that can make the child appear drunk. These children have trouble knowing where their hands and feet are in space, causing balance and coordination issues.
  • Athetosis is inappropriate movements of the body. The arms, legs mouth or tongue may writhe constantly or only when the child is distracted. Both types of dyskinetic cerebral palsy may happen in a child who also shows some evidence of spastic cerebral palsy. They may also  happen alone. Because of the unpredictable movements with dyskinesia, joints usually do not become as tight. That makes bracing and surgery less common. If it is necessary, the outcome is not as predictable as with spastic cerebral pals

Both spastic and dyskinetic cerebral palsy can be divided by the part of the body affected. This can be harder to identify in young children, but usually becomes apparent as the child grows.

Hemiplegic cerebral palsy

Affects one side of the body, right or left. Most of these children meet their developmental milestones on time, or are only very slightly delayed. Not just the arm and leg are affected, but the trunk muscles on that side are involved as well. This sometimes causes one hip to “pull up” making that leg shorter.

Diplegia cerebral palsy

Affects the legs primarily. It may affect the arms as well, but usually does not limit the child’s ability to use his or her arms. One side may be more affected than the other, leading some health-care providers to refer to this as “diplegia with a hemiplegic pattern.” A child with this type of cerebral palsy is usually delayed in their developmental milestones, and may walk on their toes. It is important to realize that not all children who walk on their toes have cerebral palsy.

Quadriplegic cerebral palsy

Affects the arms and legs. One side may be more affected than the other. Because so much of the body’s muscle is affected, these children are usually very delayed in milestones and may not walk. Continued therapy is important so the child maximizes his or her abilities. These children must be watched for the possibility of hip problems that may lead to painful hip dislocation. Diagnosis of a “hip at risk” for dislocation may be made by X-ray, and treated with surgery if necessary. Scoliosis is more common in this type of cerebral palsy than in other types due to the severity of muscle involvement. Treatment focuses on increasing time standing to improve the position of the spine and hips, which may help to prevent issues.

Developmental-behavioral pediatrics and Genetics – 5347

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