Types of Cerebral Palsy
There are various types of cerebral palsy:
Spastic
Spastic cerebral palsy is characterized by increased muscle tone, retained primitive reflexes in affected areas of the body, and slow, constrained movement. Impairment ranges from inability to isolate finger movements to inability to reach and grasp. Permanent shortening of muscles or joints, known as contractures, cause deformities.
Spastic hemiplegia
Spastic hemiplegia is characterized by deficits in movement on one entire side of the body. The head, neck, and trunk are affected; more severely affected are the upper extremities. Spasticity develops gradually and increased during physical activity and emotional excitement. Righting and equilibrium reactions are lacking and the child will not bear weight on the affected side.
Spastic displegia
In spastic displegia, both lower extremities are affected and upper extremities have mild incoordination, tremors, and less spasticity. This form of CP is linked to premature birth and low birth weight. The child’s ability to sit is delayed due to inadequate hip flexors, extensors , and adductor with hypertonicity. Clinicians are to watch for contractures and deformities such as kyphosis and lordosis.
Spastic Quadriplegia
Involves all four limbs. Lower extremities show spasticity in extensor muscles and upper extremities demonstrate spasticity in flexor muscles. In the supine position, the shoulders are especially retracted and the neck hyperextended. In the pronated position head straightening is difficult and weight bearing on the arms occurs. Facial musculature is also affected; mastication, swallowing, and drooling difficulties arise. Clinicians should also be aware of potential hip dislocation and scoliosis.
Athetosis
In contrast to spasticity, where hypertonicity and restricted movement are highlighted, athetosis is characterized by fluctuating tone and excessive movement. It is also the most common form of dyskinesia or dystonia. This form of CP involves difficulty or distortion of voluntary movement as well as involuntary movement characterized by prolonged contractions, respectively. Involuntary movements of the face and extremities as well as proximal parts of the limbs and trunk are also seen. Jerky and abrupt movements in distal movements may also develop.
Dysarthria involves difficulties articulating speech and eating as a result of disturbances in muscular control caused from the central and peripheral nervous system.
Ataxia
Ataxia is characterized by a staggering unsteady gait. Quick steps are usually taken to compensate for lack of balance and control. Hypertonicity, clumsy movements and intention tremors are often present. The ability to hand-write is affected (Atchison & Diette, 2012)
Mixed Cerebral Palsy
When muscle tone is too low in some muscles and too high in other muscles. One fourth of individuals with CP have this type (United Cerebral Palsy, 2010).
Typical arm and leg positioning can be seen in the image extrapolated from the article by Koman et al. (2004).
- Spastic; hemiplegia, diplegia, and quadriplegia
- Athetosis
- Ataxia
Spastic
Spastic cerebral palsy is characterized by increased muscle tone, retained primitive reflexes in affected areas of the body, and slow, constrained movement. Impairment ranges from inability to isolate finger movements to inability to reach and grasp. Permanent shortening of muscles or joints, known as contractures, cause deformities.
Spastic hemiplegia
Spastic hemiplegia is characterized by deficits in movement on one entire side of the body. The head, neck, and trunk are affected; more severely affected are the upper extremities. Spasticity develops gradually and increased during physical activity and emotional excitement. Righting and equilibrium reactions are lacking and the child will not bear weight on the affected side.
Spastic displegia
In spastic displegia, both lower extremities are affected and upper extremities have mild incoordination, tremors, and less spasticity. This form of CP is linked to premature birth and low birth weight. The child’s ability to sit is delayed due to inadequate hip flexors, extensors , and adductor with hypertonicity. Clinicians are to watch for contractures and deformities such as kyphosis and lordosis.
Spastic Quadriplegia
Involves all four limbs. Lower extremities show spasticity in extensor muscles and upper extremities demonstrate spasticity in flexor muscles. In the supine position, the shoulders are especially retracted and the neck hyperextended. In the pronated position head straightening is difficult and weight bearing on the arms occurs. Facial musculature is also affected; mastication, swallowing, and drooling difficulties arise. Clinicians should also be aware of potential hip dislocation and scoliosis.
Athetosis
In contrast to spasticity, where hypertonicity and restricted movement are highlighted, athetosis is characterized by fluctuating tone and excessive movement. It is also the most common form of dyskinesia or dystonia. This form of CP involves difficulty or distortion of voluntary movement as well as involuntary movement characterized by prolonged contractions, respectively. Involuntary movements of the face and extremities as well as proximal parts of the limbs and trunk are also seen. Jerky and abrupt movements in distal movements may also develop.
Dysarthria involves difficulties articulating speech and eating as a result of disturbances in muscular control caused from the central and peripheral nervous system.
Ataxia
Ataxia is characterized by a staggering unsteady gait. Quick steps are usually taken to compensate for lack of balance and control. Hypertonicity, clumsy movements and intention tremors are often present. The ability to hand-write is affected (Atchison & Diette, 2012)
Mixed Cerebral Palsy
When muscle tone is too low in some muscles and too high in other muscles. One fourth of individuals with CP have this type (United Cerebral Palsy, 2010).
Typical arm and leg positioning can be seen in the image extrapolated from the article by Koman et al. (2004).
Additional Sites
Visit http://cerebralpalsy.org/about-cerebral-palsy/types/ for more information on types an forms of cerebral palsy.