A group of disorders affecting the coordination and muscle movement in the body is known as cerebral palsy (CP). It has several different types; in many cases, cerebral palsy also affects hearing, sensation, and vision.
Entomologically, "cerebral" means something concerned with the brain, whereas "palsy" means problems or weakness in body movement.
Symptoms of cerebral palsy
Generally, the symptoms of cerebral palsy differ from one person to another and range from mild to severe in their intensity. For example, some people with cerebral palsy may experience trouble sitting or walking, while others may have difficulty holding and grasping objects. However, at the baseline, it affects a child's growth and limits their motor skill development.
Some of the most common symptoms of cerebral palsy are:
- Development delays in motor skills such as sitting, rolling, grasping, crawling, etc.
- Delayed walking or difficulty in walking
- Muscle tone variation where they are either too stiff or too floppy
- Muscle stiffness, spasticity, or exaggerated reflexes
- Lack of muscle coordination when they move
- Involuntary movements or tremors in the body
- Delayed speech development or speaking difficulties
- Problem with swallowing and excessive drooling
- Favoring one side or reaching with one hand
- Seizures, blindness, intellectual disabilities, or any other neurological issues
Most kids are born with cerebral palsy, but the signs may not become evident months or even years later. And while the exact reason cerebral palsy happens is still unknown, there is a basic understanding that atypical brain development or birth injury to the brain causes cerebral palsy. There are several different types of cerebral palsy, each with different symptoms. The types of cerebral palsy and their effects on newborn children are:
1. Spastic cerebral palsy
The most common type of cerebral palsy, amounting to up to 80% of the cases, is spastic cerebral palsy. It causes the patient to experience spasticity or exaggerated body reflexes. They also have stiff muscles, which are often painful. In most cases, the child experiences difficulty in movement and walking, depending on the intensity. Spastic cerebral palsy has further three subtypes, which are:
Spastic diplegia: It causes muscle stiffness, especially in the legs and arms, and makes walking difficult. The signs of diplegic cerebral palsy are detected as early as infancy when the baby cannot achieve developmental milestones. One sign that physicians look for when diagnosing diplegic cerebral palsy is when a toddler or infant uses their arms to crawl, not their legs, or doesn't crawl at all.
Spastic hemiplegia: The condition impacts the body's mobility on one side, limiting movements from that side. But with physical therapy, the child can learn to adapt and even learn to walk.
Spastic quadriplegia: Characterized by dysfunctionality in all motor skills, this happens to be the most severe type of spastic cerebral palsy and is often accompanied by other types of disorders as well. The children who have spastic quadriplegia often have spinal deformities, feeding and language disorders, muscle contractions, cognitive issues, and seizures.
2. Dyskinetic cerebral palsy
The second most common type of cerebral palsy is dyskinetic cerebral palsy. It is identified by abnormalities in the legs, hands, and arms, which make it difficult to coordinate and control body movement. Children who have dyskinetic cerebral palsy experience writhing and slow movements or even exhibit jerk movements. It can make sitting and walking difficult for them. Moreover, muscle tone can change from loose to tight on days, which can cause them to face difficulty while controlling their tongue and face movements, hence the speech disabilities. Some movement disorders seen in dyskinetic cerebral palsy are:
Dystonia: In this case, the movements become repetitive, which can happen in one particular part of the body or throughout the body. These movements are involuntary and come after a sequence of voluntary movements.
Athetosis: This type happens with writing and slow movements coupled with extreme level muscle fluctuations, which makes it extremely difficult to maintain a posture.
Chorea: Chorea causes fidgety, abrupt, and unpredictable movements that can make the patient appear clumsy and uncoordinated.
These different movements can happen separately or exist together in a series of combinations. But at the baseline, they cause issues in fine motor skills and result in gross motor dysfunction.
3. Ataxic cerebral palsy
Children who experience ataxic cerebral palsy can show signs of uncoordinated movements. Ataxic cerebral palsy is very rare. In this case, the movements a child exhibits are involuntary and are initiated by a series of voluntary movement efforts. These movement efforts get interrupted and uncontrolled, which causes a lack of coordination or balance. As a result, children with ataxic cerebral palsy experience difficulties in writing, walking, swallowing, speaking, and even seeing since their eye movements get affected as well.
4. Mixed cerebral palsy
As the name suggests, a mix of different types of cerebral palsy is known as mixed cerebral palsy. One of the most common combinations of spastic and dyskinetic cerebral palsy in children. However, any blend can occur. Hence, the symptoms the child experiences depend on what blend of cerebral palsy they are suffering from. In the case of mixed CP, additional medical problems, as well as other associated disorders, can occur.
Common symptoms of mixed cerebral palsy
- Floppy or spastic movements
- Involuntary movements and stiff muscles
- Cognitive issues
- Issues while swallowing or speaking
- Excessive drooling
- Facial grimaces
- Hearing problems
- Lazy eye, cortical blindness, or other vision problems
To diagnose the type of cerebral palsy a child is experiencing, the physician goes through their history, conducts a physical examination, and may even need some tests or imaging. However, one of the most common giveaways of cerebral palsy is gross motor function disabilities.
To determine the developmental delays in gross motor functions and measure the severity, gross motor classification system is used. This system is designed to do an in-depth exam of the child's physical weaknesses and abilities. Then according to the diagnosis, the doctor may refer the use of assistive aids, surgery, or medication. Assistive aids include body braces, hearing aids, walking aids, glasses, wheelchairs, etc. At the same time, muscle relaxants are given to treat spasticity.
In case of surgery, the doctor may refer it to improve mobility and reduce pain. It is mostly done to deal with bone irregularities and tight muscles. Apart from that, your doctor may also refer physical therapy, occupational therapy, speech therapy, psychotherapy, recreational therapy, and social services consultation according to the case.