SPASTIC CEREBRAL PALSY

Spastic cerebral palsy refers to a specific set of physical symptoms related to abnormal muscle control.  If muscle tone is too high or too tight, the term spastic is used to describe the type of cerebral palsy. Children with spastic CP have stiff and jerky movements because their muscles are too tight. They often have a hard time moving from one position to another or letting go of something in their hand.

Spastic Cerebral Palsy affects 70 to 80 percent of patients and is the most common form of cerebral palsy. Doctors will often describe which type of spastic cerebral palsy a patient has based on which limbs are affected, i.e spastic diplegia (both legs) or left hemi-paresis (the left side of the body). The names given to these types combine a Latin description of affected limbs with the term plegia or paresis, meaning paralyzed or weak. In some cases, spastic cerebral palsy follows a period of poor muscle tone (hypotonia) in the young infant.

Individuals with spastic cerebral palsy exhibit increased reflexes and muscle tone, tight muscles, and joint contractures. People with spastic cerebral palsy have poor balance and difficulty controlling body movements, especially in their arms and legs.

Spastic cerebral palsy has a number of adverse effects, including constricted movement, limited flexibility, and deformed joints. Spastic cerebral palsy patients can develop severe deformities over time due to spastic muscles and limited use/flexibility. Currently, spastic cerebral palsy symptoms can currently only be controlled, as there is no known cure. Doctors treat spastic cerebral palsy patients in an attempt to relax muscles or to correct deformities. Treatments for spastic cerebral palsy include Botox (botulinum A toxin) injection, baclofen infusion, orthopedic surgery, physical therapy, and braces.

Spastic cerebral palsy symptoms can be temporarily relieved through the use of Botox and baclofen, while surgery on spastic cerebral palsy patients is generally intended to treat the consequences of spasticity, thereby increasing range of motion. Spastic cerebral palsy patients who undergo surgery risk major side effects, including permanent muscle weakness and deformity.

ATHETOID CEREBRAL PALSY

The term athetoid is used to describe the type of cerebral palsy when muscle tone is mixed - sometimes too high and sometimes too low. Children with athetoid CP have trouble holding themselves in an upright, steady position for sitting or walking, and often show lots of movements of their face, arms and upper body that they don't mean to make (random, involuntary movements). These movements are usually big. For some kids with athetoid CP, it takes a lot of work and concentration to get their hand to a certain spot (like to scratch their nose or reach for a cup). Because of their mixed tone and trouble keeping a position, they may not be able to hold onto things (like a toothbrush or fork or pencil). About one-fourth of all people with CP have athetoid CP.

Athetoid cerebral palsy (also called dyskinetic) results from damage to the cerebellum or basal ganglia. In more severe cases, athetoid cerebral palsy involves the muscles of the face, causing drooling and grimacing. Patients with athetoid cerebral palsy generally experience increased movements during periods of emotional distress.

Athetoid cerebral palsy affects 10-20% of cerebral palsy patients. Generally speaking, athetoid cerebral palsy involves the entire body, rather than being restricted to one region. Within the athetoid cerebral palsy community, a large percentage of individuals have been identified as having above average intelligence. Athetoid cerebral palsy should not be confused with adult onset dystonia, although the symptoms are the same-athetoid cerebral palsy is not degenerative in nature, while adult onset dystonia is. People who suffer from athetoid cerebral palsy may be given medication to reduce abnormal movements and drooling.

ATAXIC CEREBRAL PALSY

Ataxic cerebral palsy, the most rare form of cerebral palsy, represents only 5-10% of existing cases. Ataxic cerebral palsy results in low muscle tone, causing limbs to appear floppy and loose and stems from damage to the spinal cord and cerebellum and affects the entire body. Ataxic cerebral palsy is characterized by the effects of interruption in the brain's center for balance; ataxic cerebral palsy disrupts balance and depth perception, resulting in poor coordination. Individuals who have ataxic cerebral palsy place their feet far apart, walk unsteadily and have difficulty moving precisely.

Ataxic cerebral palsy causes "intention tremors," which begin with voluntary motion and increase dramatically. This effect of ataxic cerebral palsy becomes more pronounced when the individual is trying to hold something small. People with ataxic cerebral palsy take longer to complete tasks due to problems coordinating their movements. Ataxic cerebral palsy especially affects the fine motor skills-writing, for instance, becomes very difficult. Individuals with ataxic cerebral palsy often have trouble reaching for objects, as a result of their affected depth perception. Ataxic cerebral palsy can also cause jerky speech patterns. Ataxic cerebral palsy is the only form of cerebral palsy that worsens as the victim grows older.

MIXED CEREBRAL PALSY

When muscle tone is too low in some muscles and too high in other muscles, the type of cerebral palsy is called mixed. About one-fourth of all people with cerebral palsy have mixed cerebral palsy.The most common mixed form includes spasticity and athetoid movements but other combinations are also possible.

QUADRIPLEGIA CEREBRAL PALSY

When a child shows cerebral palsy in all four of their limbs--both arms and both legs, it is called quadriplegia. Usually, children with quadriplegia have trouble moving all the parts of their bodies, their face and trunk as well as their arms and legs, and may need a wheelchair to get around. Because of the problems controlling the muscles in their face and upper body, they also have trouble talking and eating.

HEMIPLEGIA CEREBRAL PALSY

Hemiplegia means that the CP affect one side of the child's body. Hemi means half, so the right arm and leg or the left arm and leg are affected. The other side of the child's body works just fine. Many kids with hemiplegia are able to walk and run, although they may look a little awkward or have a limp.

DIPLEGIA CEREBRAL PALSY

Some children have CP just in their legs or much more severe in their legs than in their arms. This is called diplegia. Di means two, so in diplegia only the two lower limbs are affected. As you probably can guess, the difficulty for children with diplegia is using their legs, so walking and running may be hard for them. Because their upper bodies are usually not affected they have good ability to hold themselves upright and good use of their arms and hands. You may wonder whether anyone ever has CP in their arms but not their legs. This happens sometimes, but it is very, very rare.

DISORDERS SIMILAR TO CEREBRAL PALSY

Children with disabilities have many problems in common, especially problems involving interactions with family members and society at large. The physical and medical problems of children with disabilities vary widely, however. Some of the problems caused by various disorders resemble those affecting children with cerebral palsy, but on closer inspection the medical issues turn out to be quite distinct.

Children with spinal cord dysfunction, for example, face medical problems such as insensate skin and bowel and bladder dysfunction, which differ markedly from the medical problems faced by children with cerebral palsy. Spinal cord dysfunction may be a result of spinal cord injury, spina bifida (meningomyelocele), or a congenital spinal cord malformation. Another large group of children who at time may look similar to those with cerebral palsy are children with temporary motor problems resulting from closed head injuries, seizures, drug overdoses, or some brain tumors. The medical issues for this group of children are also different from the medical issues for children with cerebral palsy, because these injuries can occur at any age and the severity of the problems caused by these injuries changes over time. We can also say that disorders that are primarily of muscle, nerve, and bone are not cerebral palsy by definition.

Such conditions include muscular dystrophy, peripheral neuropathies such as Charcot-Marie- Tooth disease, and osteogenesis imperfecta. All of these conditions are associated with specific medical problems. Children with progressive neurologic disorders (including Rett's syndrome, leukodystrophy, and Tay-Sach's disease) also have medical needs which are different from those of children with cerebral palsy.

Some children with chromosomal anomalies (for example, trisomy 13 and 18) or congenital disorders (hereditary spastic paraplegia, for example) may appear similar to children with cerebral palsy; others, such as children with Down's syndrome, appear very different from children with cerebral palsy. Children with these disorders have some problems in common with children who have cerebral palsy; they also have problems that are unique for children with that specific disorder.