Types of Cerebral Palsy Explained
Cerebral palsy is the name for a group of conditions caused by brain damage while a baby or young child’s brain is still developing. These conditions affect movement, balance, and posture, and can have a very significant impact on a person’s wellbeing and quality of life.
In this article, we cover different types of cerebral palsy, including their causes and effects. If you are considering making a cerebral palsy compensation claim, this can be a vital step to make sure funding is in place for the very best treatment and support.
Dyskinetic (or athetoid) cerebral palsy
Dyskinetic cerebral palsy causes involuntary and uncontrollable movement because of damage to the basal ganglia of the brain. This part of the brain is responsible for interpreting messages between the movement centre and the spinal cord. Different parts of the basal ganglia control different movements in the body and injury can cause different types of involuntary movements:
- Dystonia – twisting and repetitive movements caused by involuntary muscle contractions that often result in awkward postures and painful movements.
- Athetosis – slow, continuous, involuntary writhing movements, present at rest and made worse when attempts are made to move. Maintaining posture (i.e., sitting) is difficult.
- Chorea – brief, abrupt, irregular, and unpredictable involuntary movement. This can affect various parts of the body including speech and swallowing.
Common symptoms associated with dyskinetic cerebral palsy can include:
- A stiff or rigid body.
- Floppiness in the limbs.
- Problems with posture.
- Feeding difficulties.
Developmental delay and learning difficulties may also be seen to occur with this condition.
Spastic cerebral palsy
The other more common type of cerebral palsy is called spastic cerebral palsy which is caused by damage to the motor cortex of the brain. The motor cortex is involved in the planning, control and execution of voluntary movements and injury to it, in this context, results in people suffering from hypertonia, or increased muscle tone, causing movements to look stiff and jerky. Spastic cerebral palsy accounts for around 70-80% of all children diagnosed with this condition.
The damaged motor cortex cannot properly control muscle movements and cannot turn the correct muscle groups on and off as required. It might, for example, turn different groups of muscles on at the same time (whereas a motor cortex without damage would turn off one group of muscles) or turn two muscle groups on simultaneously. Movement, therefore, becomes extremely difficult and, dependent on the damage to the motor cortex, can affect the arms and hands, legs, and speech.
Developmental delay and learning difficulties may also be seen in some babies and children diagnosed with spastic cerebral palsy.
Spastic cerebral palsy is further sub-divided into different categories depending on the number of limbs and areas of the body it affects:
- Quadriplegic cerebral palsy
- Diplegic cerebral palsy
- Hemiplegic cerebral palsy
- Ataxic cerebral palsy
You can read more about these types of spastic cerebral palsy in the sections below.
Quadriplegic cerebral palsy
This condition is when all four limbs (both arms and legs) are affected. It is marked by stiff or permanently contracted muscles and largely affects the facial and core muscle groups.
The severity of quadriplegic cerebral palsy will vary from child to child. Some can sit by themselves, walk short distances (possibly with an aid), and perform simple tasks whereas others may require around-the-clock care for the rest of their lives.
Symptoms of quadriplegic cerebral palsy usually become apparent from 3 months to 2 years of age. Parents may notice their baby suffering with limited control of their head and falling behind with developmental milestones: first crawling and walking, for example. The condition can also result in bowel and bladder problems because of muscular problems.
Diplegic cerebral palsy
This condition, also known as spastic diplegia or bilateral cerebral palsy, causes tense muscles and spasms mainly affecting the legs. The leg muscles become very tight, which, over time, causes a child’s joints to stiffen, meaning they cannot move very efficiently.
Common symptoms and characteristics of diplegic cerebral palsy may include:
- Inability to crawl and reliance on upper limbs rather than legs to move.
- Unable to stand without assistance by aged 3 years of age.
- “Pigeon-Toed” walking.
- A “Scissor Gait” walk.
- Developing spastic hip disease.
- Inability to walk long distances.
- Muscles in the leg quickly going from stiff and rigid to floppy.
Most children with this condition are diagnosed at around 3 years of age.
Hemiplegic cerebral palsy
Hemiplegia means paralysis on one half of the body. With hemiplegic cerebral palsy a child will suffer paralysis on one side of the body opposite to the side of the brain where the injury occurred; left sided brain injury will, for example, cause right-sided paralysis.
Common symptoms and characteristics of hemiplegic cerebral palsy may include:
- Stiff and weak muscles on one side of the body.
- One hand on the affected side constantly bunched up into a fist.
- Difficulty with walking and balance.
- Delay in fine motor skills developing.
- Delay in reaching milestones: sitting, crawling, and walking.
- Higher risk of developing scoliosis (curvature of the spine).
Ataxic cerebral palsy
The least common form of cerebral palsy is ataxia, which is caused by injury to the cerebellum, the balance centre of the brain that fine tunes movement. Ataxic cerebral palsy causes clumsy and jerky movements when attempting to perform voluntary movements, such as picking up objects, because of the interruption of smooth muscle control. It can also cause shaky movements and a tremor.
Common symptoms associated with ataxic cerebral palsy can include:
- Walking with feet spread far apart.
- Difficulty bringing hands together.
- An unsteady gait.
- Trouble grasping objects.
- Over correcting movements.
- Difficulty with repetitious movements.
- Trouble with speech.
- Slow eye movements.
Most children are not diagnosed with ataxic cerebral palsy until aged around 18 months old.
Mixed type cerebral palsy
Some children may suffer from mixed type cerebral palsy with some or all of the above conditions.This is not uncommon.