The term cerebral palsy refers to any one of a number of neurological disorders that appear ininfancy or early childhood and permanently affect body movement and muscle coordination but don’tworsen over time. Even though cerebral palsy affects muscle movement, it isn’t caused by problems in themuscles or nerves. It is caused by abnormalities in parts of the brain that control muscle movements. Themajority of children with cerebral palsy are born with it, although it may not be detected until months or years later. The early signs of cerebral palsy usually appear before a child reaches 3 years of age. The mostcommon are a lack of muscle coordination when performing voluntary movements (ataxia); stiff or tightmuscles and exaggerated reflexes (spasticity); walking with one foot or leg dragging; walking on the toes, acrouched gait, or a “scissored” gait; and muscle tone that is either too stiff or too floppy. A small number of children have cerebral palsy as the result of brain damage in the first few months or years of life, braininfections such as bacterial meningitis or viral encephalitis, or head injury from a motor vehicle accident, afall, or child abuse.Cerebral palsy may be classified by the type of movement problem (such as spastic or athetoid cerebral palsy) or by the body parts involved (hemiplegia, diplegia, and quadriplegia). Spasticity refers to the inabilityof a muscle to relax, while athetosis refers to an inability to control the movement of a muscle. Infants whoat first are hypotonic wherein they are very floppy may later develop spasticity. Hemiplegia is cerebral palsythat involves one arm and one leg on the same side of the body, whereas with diplegia the primaryinvolvement is both legs. Quadriplegia refers to a pattern involving all four extremities as well as trunk andneck muscles. Another frequently used classification is ataxia, which refers to balance and coordination problems. The motor disability of a child with CP varies greatly from one child to another; thusgeneralizations about children with cerebral palsy can only have meaning within the context of the subgroupsdescribed above. For this reason, subgroups will be used in this book whenever treatment and outcomeexpectations are discussed. Most professionals who care for children with cerebral palsy understand thesediagnoses and use them to communicate about a child's condition.
Spastic Cerebral Palsy
Spastic Cerebral Palsy is the most common diagnosis. If your child’s CP is “spastic,” her muscles are rigidand jerky, and she has difficulty getting around. There are three types of spastic Cerebral Palsy:
— Your child’s leg and hip muscles are tight, and his legs cross at the knees, makingit difficult to walk. This kind of movement is frequently referred to as “scissoring.”
— Only one side of your child’s body is stiff. Her arms or hands might be moreaffected than her legs. On the affected side, her arm and leg may not develop normally. She may alsorequire leg braces.
— The severest of the three, spastic quadriplegia means that your child is morelikely to have mental retardation if diagnosed as quadriplegia. His legs, arms, and body are affected.It will be difficult for him to walk and talk, and he may also experience seizures.
Athetoid Dyskinetic Cerebral Palsy
Athetoid dyskinetic is the second most frequently diagnosed type of Cerebral Palsy. Your child will havenormal intelligence, but her body will be totally affected by muscle problems. Her muscle tone can be weak or tight, and she might have trouble walking, sitting, or speaking clearly. She may also have troublecontrolling her facial muscles and therefore drool.
Ataxic Cerebral Palsy
This is the least diagnosed type of Cerebral Palsy. Your child will have trouble tying his shoes, buttoning hisshirt, cutting with scissors, and doing other tasks that require fine motor skills. He might walk with his feetfarther apart than normal and have trouble with his balance and coordination. Your child may also suffer from “intention tremors,” a shaking that begins with a voluntary movement. For example, your child mayreach for a toy, and then his hand and arm will start to shake. As he gets closer to the toy, the tremor worsens.
Hypotonic Cerebral Palsy