What Are the Different Types of Cerebral Palsy?
Cerebral means "brain" and palsy means "lack of muscle control." Together they indicate a physical disability that impacts a person's movement and posture. The term cerebral palsy is technically an umbrella term for a variety of disorders that affect mobility. Cerebral palsy (CP) is caused by damage to the brain that either develops in utero or shortly after birth, and there are various types of cerebral palsy.
When describing CP, it can be done in one of two ways: either by body part or by the injured area of the brain. For today's article, we will look into types and symptoms of this condition and how people can find support through medication and therapies. We will also cover how to improve one’s physical well-being and achieve independence in daily life.
1. Spastic Cerebral Palsy
Spastic cerebral palsy is the most common type. It effects around 80% of people with CP. It’s characterized by stiff muscles due to excess muscle tone. This is caused by damage to the motor cortex in the brain. It specifically impacts bundles of neurons in the brain and spinal cord that are called the corticospinal tracts and corticobulbar tracts.
The muscles become stiff due to the messages that are sent incorrectly through the damaged part of the brain. Often, the faster a person with spastic CP tries to move their limbs, the stiffer the muscles look.
Signs of Spastic Cerebral Palsy
People with spastic CP may show different symptoms, depending on which parts of the body are affected. However, some common patterns include:
- Bending at the elbow or wrist.
- Fisting of the fingers.
- Adduction of the legs/thighs, which causes them to pull together.
- Flexion at the hips and/or knees.
- Toes that point down and inwards, with a lifted heel.
- Tightness of facial muscles, such as the tongue, mouth and vocal folds.
- This tightness can cause difficulty with speech, eating and/or a hoarseness to the voice.
These physiological effects can impact someone's ability to:
- Sit and/or stand upright.
- Move from one position to another.
- Walk and/or run.
- Eat or drink.
- Write or manipulate objects.
- Get dressed, clean and/or go to the bathroom.
Spastic muscles don't always stretch and grow as efficiently, which can lead to shorter muscles and bones that cannot achieve their full range of motion.
2. Dyskinetic Cerebral Palsy
The second type of CP is called dyskinetic, or athetoid cerebral palsy. It occurs in about 6% of people with the condition. It is characterized by involuntary movements caused by damage to the basal ganglia. These movements occur because the basal ganglia acts as an interpreter between the movement center and the spinal cord. It can often occur alongside spastic CP.
There are three categories of involuntary movement seen within dyskinetic CP:
- Dystonia: caused by involuntary muscle contractions. They can lead to slow, twisting, or repetitive movements. They can occur in one spot (focal dystonia) or throughout (generalized dystonia) of the body.
- Athetosis: these movements are slow, continuous, involuntary, writhing movements. They are present at rest and made worse by attempts to move. People with athetosis have fluctuating muscle tone, from floppy to extremely variable movement. This can cause issues with controlling movement, standing and posture.
- Chorea: these movements are brief, abrupt, irregular and unpredictable. The severity can range from mild (appearing as clumsiness) to severe, with larger, wilder movements. It may co-occur with both dystonia and athetosis.
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3. Ataxic Cerebral Palsy
Ataxic cerebral palsy is the least common form, impacting about 6% of people with the condition. It is caused by damage to the cerebellum, which causes shaky movements and can affect balance and body positioning.
Ataxia is characterized by:
- Imprecision, clumsiness, or instability.
- Shaky, unsteady movements and possible tremors.
- Issues maintaining balance.
- Issues with depth perception.
- An impact on various parts of the body, from fingers to arms, legs, speech, muscles involved with swallowing and eye movements.
4. Mixed Cerebral Palsy
Finally, some people who have cerebral palsy have damage in several parts of the brain, which means they may present with signs from each type.
Treatments for Cerebral Palsy
Since there are difference types of cerebral palsy and numerous ways symptoms can present, treatment varies across the board. Some standard treatments include medications, surgery and therapies. Generally, the earlier the treatment, the better the physical outcome is.
There are different medications that can help symptoms, such as muscle tightness, chronic pain and other complications. They include:
- Injections to treat muscle and nerve tightness (Botox or other types).
- Medications to reduce drooling.
- Muscle relaxants, which can be taken by mouth or through an implant in the abdomen, depending on severity and need.
There are a range of therapies that can be helpful when it comes to improving range of motion, independence, physical abilities and speech. Depending on the symptoms, your doctor may recommend one or more of the following:
1. Speech and/or Language Therapy
This therapy is great for learning sign language, improving communication skills and eating habits and learning how to use communication devices.
2. Physical Therapy
Physical therapists can share exercises to help with muscle tone, strengthening, range of motion and flexibility. They can also provide wheelchair assessments.
3. Occupational Therapy
These therapists are great for helping people gain independence through their daily routines. They can also recommend adaptive equipment, such as canes, walkers, wheelchairs and standing and sitting systems.
Cerebral palsy is a disability that has a broad range of symptoms. There are several types of cerebral palsy that are characterized by the location of the damage to the brain, which can look different by case. Treatment options depend on an individual’s need and are designed by healthcare practitioners.