36 / Ped iatrics

Ta ble 2-6. Cla ssifica t ion a n d Ch a r a ct er ist ics of Types of Cer ebr a l P a lsy

Ty p e a n d D e s c rip tio n Clin ic a l Clu e s Ris k F a c to rs

S p a s tic c e re bra l p a ls y
S p a s tic d ip le g ia
Wea kn ess t h a t in volves t h e
lower ext r em it ies m or e t h a n
t h e u pper ext r em it ies or fa ce
S p a s tic h e m ip le g ia
Un ila t er a l spa st ic m ot or
wea kn ess
S p a s tic qu a d rip le g ia
Mot or in volvem en t of h ea d,
n eck, a n d a ll fou r lim bs
Ex tra p y ra m id a l
(n o n s p a s tic ) c e re bra l p a ls y
In volvem en t of ext r a pyr a m ida l
m ot or syst em , r esu lt in g in
a th e to id m ovem en t s
P r oblem s in volve m odu la t in g
con t r ol of t h e fa ce, n eck,
t r u n k, a n d lim bs
Ar m s a r e u su a lly m or e a ffect ed
t h a n legs
Or a l m ot or in volvem en t m a y
be pr om in en t
CN S = cen t r a l n er vou s syst em .
H ist or y of ea r ly r ollin g over P r em a t u r it y
In cr ea sed t on e
“S c is s o rin g ” (ext en sion a n d
cr ossin g of t h e lower
ext r em it ies wit h st a n din g or
ver t ica l su spen sion ; a sign
of spa st icit y)
Upper ext r em it y in volvem en t P er in a t a l va scu la r
is t ypica lly gr ea t er t h a n in su lt s, post n a t a l
lower ext r em it ies t r a u m a , CNS
E a r ly h a n d pr efer en ce (u n u su a l m a lfor m a t ion s
in n or m a l in fa n t s befor e 18
m on t h s of a ge)
At t em pt s a t gr a spin g a lwa ys on
t h e sa m e side a n d fist in g or
a bsen t pin cer on on e side
Seizu r es H ypoxic-isch em ia
Scoliosis en ceph a lopa t h y
Wea kn ess of fa ce a n d ph a r yn gea l CNS in fect ion s,
m u scles, dysph a gia trauma,
Ga st r oesoph a gea l r eflu x or m a lfor m a t ion s
a spir a t ion pn eu m on ia , fa ilu r e
t o t h r ive
Speech pr oblem s a n d sen sor y
im pa ir m en t s
Ma r ked h ypot on ia of n eck a n d F u ll-t er m in fa n t wit h
t r u n k, lim it in g ch ild’s a bilit y t o h ypoxia -isch em ia
explor e t h e en vir on m en t Ker n ict er u s lea din g t o
Movem en t disor der con sist in g of ba sa l ga n glia da m a ge
in t er m it t en t post u r in g or
m ovem en t of h ea d, n eck,
a n d lim bs
P r oblem s wit h feedin g, speech ,
a n d dr oolin g beca u se or a l
m ot or fu n ct ion is im pa ir ed

(a ) S p a s tic d ip le g ia in volves t h e lower ext r em it ies m or e t h a n

t h e u pper ext r em it ies or fa ce.
(b) S p a s tic h e m ip le g ia is ch a r a ct er ized by u n ila t er a l spa st ic
m ot or wea kn ess.
(c ) S p a s tic qu a d rip le g ia is ch a r a ct er ized by m ot or in volve-
m en t of t h e h ea d, n eck, a n d a ll fou r lim bs.
(2) Ex tra p y ra m id a l c e re bra l p a ls y (com m on ly r efer r ed t o a s
a th e to id c e re bra l p a ls y ). Th ese pa t ien t s h a ve pr oblem s m odu -