Involvement of all four limbs and the trunk. The alternative name iswhole body involvement.
Classification according to movement disorders
Spastic or Pyramidal-
Characterised by muscles and joints that are tight andinability to stretch them. Child walks on toes or legs make scissors movements.b.
Non spastic or Extrapyramidal-
Characterised by twisting, jerking, or writhing of the hands, feet, arms, or legs while awake, worse during periods of stress e.g.Dyskinetic, athetoid, chorea, ataxia, hypotonia.c.
Characterized by hypotonia, hyporeflexia with intention tremors.d.
Diffused neurological involvement.
The signs of cerebral palsy are usually not obvious in early infancy but become more clear as thenervous system matures.
Delayed milestones such as controlling head, rolling over, reaching with one hand, sitting withoutsupport, crawling, or walking.Persistence of infantile or primitive reflexes, which usually vanish 3-6 months after birth.Developing handedness before age 18 months indicating weakness or abnormal muscle tone on oneside.Problems and disabilities related to CP range from very mild to very severe related to the severity of the brain damage.
Abnormal muscle tone
Muscles may be very stiff (spastic) or unusually relaxed and floppy. Limbs may be kept in unusual orawkward positions. Spastic leg muscles may cause legs to cross in a scissor-like position.
Movements may be uncontrolled, purposeless, unusually jerky, abrupt, slow and writhing.
One sided cerebral palsy patients may have shortened limbs on the affected side and may lead totilting of the bones and scoliosis.
Severe stiffening of the joints may appear due to unequal pressures on the joints exerted by musclesof differing tone or strength.
In some, mental retardation is seen, the more severe the retardation, the more severe the disabilityoverall.