Types of Cerebral Palsy
There are three main types of Cerebral palsy which are noticed in a child. These three types are:
- Spastic Cerebral Palsy – This the most common Cerebral palsy that is found in children. Almost eighty percent of all the Cerebral palsy cases suffer from the spastic Cerebral palsy. Children suffering from spastic Cerebral palsy may encounter stiff and jerky movements. These children have difficulties in holding objects and letting go of it. They also face difficulties while walking. This is because Spastic Cerebral Palsy tends to affect the legs of a patient more than the arms. Spastic diplegia cerebral palsy patients have more extensive involvement of the lower extremity than the upper extremity.
Spastic cerebral palsy symptoms include increased tone, or tension, in a muscle. Normal muscles work in pairs; when one group of muscles contract, the other group relaxes. This allows uninhibited movement in the desired direction. Due to complications in brain-to-nerve-to-muscle communication, the normal degree of muscle tension is disrupted. Muscles affected by spastic cerebral palsy become active together and block effective movement. This causes the muscles in spastic cerebral palsy patients to be constantly tense, or spastic. Cerebral palsy can be classified by the way it affects movement or by the number of limbs it affects. Spastic Cerebral palsy can again be divided into three types:
- Spastic diplegia
- Spastic hemiplegia
- Spastic quadriplegia
Athetoid Cerebral Palsy – This type of Cerebral palsy is not frequently seen within children. Athetoid Cerebral palsy is caused if any kind of harm is done to the cerebellum or basal ganglia. These parts of the brain are in charge of processing the signals that enable smooth movements and coordination. It also helps to maintain the right body posture. The slow, writhing movements associated with athetoid cerebral palsy usually affect the hands, feet, arms, or legs. In some cases, athetoid cerebral palsy can affect the muscles of the face and tongue, causing grimacing and drooling. The involuntary and uncontrollable muscle tone fluctuations sometimes affect the whole body. The movement caused by athetoid cerebral palsy often increases during times of heightened emotional stress. Symptoms usually tend to disappear completely during sleep.
- Ataxic Cerebral Palsy – This is a rare type of Cerebral palsy found in a few children. The ataxic cerebral palsy is detected when the child suffers from low muscle tone and very poor coordination of movements. This type of Cerebral palsy affects the sense of balance and depth perception and thus children suffering from ataxic cerebral palsy look very unsteady and shaky.
Ataxic cerebral palsy can affect an individual in several ways. A person with ataxic cerebral palsy will usually have a wide-based gait, or walk. Because of their poor sense of balance they tend to walk with their feet unusually far apart. In appearance, a person with ataxic cerebral palsy will look very unsteady and shaky. This is due to low muscle tone where the body is constantly trying to counter-balance itself.
The most significant characteristic of ataxic cerebral palsy is tremor, especially when attempting quick or precise movements, such as writing or buttoning a shirt. Also known as intention tremor, this symptom of ataxic cerebral palsy worsens when attempting a voluntary movement. For example, when reaching for an object, such as a book, the hand and arm will begin to shake. As the hand gets closer to the object the trembling gets more severe, increasing the completion time necessary for the task.
- Mixed Palsy - There can be a combination of all these three types of Cerebral palsy, which are often termed as Mixed Palsy. Children suffering from mixed Cerebral palsy have both the stiff muscle tone of spastic cerebral palsy and the uncontrolled movements of Athetoid cerebral palsy. This type of Cerebral palsy is found in ten percent of all the children suffering from the disease.
Children with mixed cerebral palsy usually have both the tight muscle tone of spastic cerebral palsy and the involuntary movements of athetoid cerebral palsy. This is caused by injury to both the pyramidal and extra pyramidal areas of the brain. Spasticity is usually the more obvious type, with the involuntary athetoid movements increasing when the child is between nine months and three years old. It usually takes months or years to notice the presence of mixed cerebral palsy more obvious.
The most common combination of mixed cerebral palsy involves both spasticity and athetoid movements, but other combinations are also possible. The least common mix is athetoid and ataxic, however any mix of types may occur. It is possible to have a mix of all three types of cerebral palsy: spastic, athetoid and ataxic.
Mixed cerebral palsy with spastic and athetoid cerebral palsy is the most common type of mixed cerebral palsy, accounting for nearly 10 percent of mixed cerebral palsy cases. Spastic cerebral palsy causes one or more tight muscle groups, which limit movement in the patient. Children with spastic cerebral palsy have stiff and jerky movements. They often have trouble moving from one position to another and have a difficulty holding and letting go of objects.
Causes of Cerebral palsy
Cerebral palsy does not have a single cause but it stems from a number of disorders that generally affect a child during the pregnancy period or the earliest stages of birth. Around ten to twenty percent of children suffering from Cerebral Palsy contract the disorder after birth but there are many more cases that are caused by an incident or accident which occurs during pregnancy or birth. This damage can occur early in pregnancy when the brain is just starting to form, during the birth process as the child passes through the birth canal, or after birth in the first few years of life. In many cases, the exact cause of the brain damage is never known.
Generally Cerebral palsy is caused by brain damage or infections like viral encephalitis, bacterial meningitis and at times even from jaundice. Any kind of accident or fall may result in Cerebral palsy. Some of the general causes of Cerebral palsy include:
- Birth Injury
- Brain Damage
- Brain Injury
- Drugs and Alcohol
- Maternal Infection
- Neonatal Infection
- Premature Birth
There are some other causes which create thousands of cases of Cerebral palsy. Medical mistakes are quite responsible for creating thousands of Cerebral palsy cases. Other important causes of cerebral palsy include accidents of brain development, genetic disorders, stroke due to abnormal blood vessels or blood clots, or infections of the brain.
Even though it is widely believed that the most common cause of cerebral palsy is a lack of oxygen to the brain during delivery (birth asphyxia), it is actually a very rare cause of cerebral palsy. When cerebral palsy is the result of birth asphyxia, the infant almost always suffers severe neonatal encephalopathy with symptoms during the first few days of life. These symptoms include:
- Seizures,
- Irritability,
- Jitteriness,
- Feeding and respiratory problems,
- Lethargy, and
- Coma depending on the severity.
In rare instances, obstetrical accidents during particularly difficult deliveries can cause brain damage and result in cerebral palsy. Conversely, it is very unlikely that cerebral palsy symptoms would develop after a few years of age as a result of obstetrical complications.
Child abuse during infancy can cause significant brain damage, which in turn, can lead to cerebral palsy. This abuse often takes the form of severe shaking from a frustrated parent or caregiver, causing hemorrhage in or just outside the brain. To further compound the problem, many children with developmental abnormalities are at risk for being abused. Thus, a child with cerebral palsy may be made significantly worse or even killed by a single incident of abuse.
Despite the diversity of causes of cerebral palsy, many cases remain without a defined cause. However, the enhanced ability to see the brain structure with magnetic resonance imaging (MRI) and CT scans as well as improved diagnostic capabilities for genetic disorders has made the number of such cases much lower.
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Article Last Updated: 06/26/2009