Cerebral palsy is a movement disorder caused by damage to or malformation of the part of the brain responsible for coordinating movement and balance. Cerebral palsy can cause a wide variety of symptoms, including muscle spasms, poor coordination, and limited mobility.
Cerebral palsy itself s not progressive – the damage doesn’t get worse over time. However, some symptoms may get progressively worse due to wear and tear on the body.
Cerebral palsy can come in a wide variety of forms and levels of severity, but it’s characterized by problems with muscle movement and coordination. That may involve twitching, spasms, difficulty performing precise motions, and more. Severe cases may result in limited mobility and inability to perform basic tasks.
In addition to trouble with movement and coordination, cerebral palsy can cause a wide variety of other mental and physical symptoms. Approximately 30-50% of children with cerebral palsy will also have intellectual or developmental disabilities. Some children with cerebral palsy may have learning difficulties, especially in areas involving spatial reasoning. Some children may have sensory disorders, causing extreme sensitivity or insensitivity to stimuli.
Cerebral palsy can cause a variety of physical side effects, including:
- Delayed physical growth
- Difficulty gaining weight
- Delayed sexual development
- Deformities of the spine, leading to twisted or curved posture
- Visual impairment, especially crossed eyes
- Hearing impairment
- Difficulty controlling muscles used in speech, causing slurred speech and drooling
- Incontinence due to lack of control of bladder muscles
- Contractures, a painful condition in which muscles lock into abnormal positions
- Inability to participate in physical activity, limiting development of strength and fitness
- Seizure disorders
These symptoms may not be present in every case of cerebral palsy; severe cases may have several or all of them.
Children with cerebral palsy may also have chronic pain due to the constant muscle spasms and the associated damage to the joints. Going forward, cerebral palsy can lead to degenerative arthritis and bone loss as the joints are stressed and weight-bearing exercise, the best defense against osteoporosis, is difficult. Cerebral palsy is hard on the body and the mind and many cerebral palsy sufferers age prematurely under the strain.
Types of Cerebral Palsy
All types of cerebral palsy may involve the side effects listed above. In addition cerebral palsy is divided into several subtypes based on specific movement- and coordination-related symptoms.
These subtypes are further divided by the parts of the body affected and the severity of the symptoms. For example, the prefixes hemi-, di-, and quad- mean half, two, and four, respectively. They indicate the parts of the body most affected by cerebral palsy. The suffixes –paresis and –plegia mean weakness and paralysis, respectively. So, quadriplegia means paralysis of all four limbs. Diparesis means weakness of the legs. Hemiparesis means weakness of either the left or right side of the body. These terms are used in conjunction with the subtypes described below, so a child might have spastic quadriparesis, or spastic cerebral palsy that causes weakness in all four limbs.
Let’s take a look at the major subtypes of cerebral palsy.
Ataxic Cerebral Palsy
Ataxic cerebral palsy is the least common form, accounting for just 5-10% of cerebral palsy sufferers. “Ataxia” refers to a lack of coordination or control, which is the main characteristic of ataxic cerebral palsy. Specifically, it affects voluntary muscle movements. Children with this type of cerebral palsy often have difficulty executing smooth and precise movements. Movements may be jerky and poorly controlled. That can make all sorts of daily tasks very difficult – from buttoning a shirt to using a fork to walking. Ataxia also affects depth perception and balance, so those with ataxic cerebral palsy may be shaky or unsteady on their feet.
Ataxic cerebral palsy is often linked to damage to the cerebellum, which controls voluntary muscle movements.
Dyskinetic Cerebral Palsy
Dyskinetic cerebral palsy is an umbrella term encompassing several different subtypes. Dyskinetic types of cerebral palsy are characterized by involuntary muscle writhing and spasms. Dyskinetic forms of cerebral palsy are identified by the type of muscle movement the disorder causes: chorea, dystonia, and athetosis.
Choreiform Cerebral Palsy
“Chorea” comes from the Greek word meaning “to dance.” People with choreiform cerebral palsy experience involuntary fidgeting and twitching. Some forms of choreoathetoid cerebral palsy are mild, with small twitches and manageable spasms, while more severe forms involve wild and dramatic movements.
The twitches and spasms associated with chorea may also occur in conjunction with other types of cerebral palsy.
Dystonic Cerebral Palsy
Dystonic cerebral palsy is characterized by involuntary, slow, twisting or repetitive muscle movements. It can also cause children to adopt unusual postures. These movements and postures may be repetitive or sustained for long periods of time. Unfortunately, the movements may also be painful.
Dystonic movements may be triggered by an attempt to control muscle movement or by fear, stress, pain, or anxiety.
Athetoid Cerebral Palsy
Athetoid cerebral palsy is characterized by slow, involuntary writhing. The writhing is often worse when the child attempts to move, but is usually present even when the child is at rest. Athetoid cerebral palsy makes it difficult for sufferers to maintain muscle tone; their muscles relax and tense or spasm involuntarily. That can make it difficult to stand or sit, let alone perform more precise movements.
Athetoid cerebral palsy often affects the entire body. Its effect on the lips and tongue typically cause some level of speech impediment.
Spastic Cerebral Palsy
Spastic cerebral palsy is the most common subtype and is associated with stiff muscles and awkward movements. It often affects just one side of the body or just the legs. In those cases, the child usually normal intelligence but may have difficulty forming clear speech. Sometimes, spastic cerebral palsy affects the entire body. This more severe form is usually accompanied by some level of intellectual disability. Children with severe spastic cerebral palsy often cannot walk and may suffer frequent seizures.
Mixed Cerebral Palsy
Not every instance of cerebral palsy fits into one of the three subtypes described above. Some children display a mix of symptoms that can’t be neatly categorized. These cases fall under the label of mixed cerebral palsy.