Cerebral Palsy Symptoms and Types

Cerebral palsy syndromes are grouped into four main categories: spastic, athetoid, ataxic, and mixed forms. Each type of cerebral palsy is characterized by different symptoms:

Spastic Cerebral Palsy - occurs in about 70% of cases. The spasticity is due to upper motor neuron involvement and may mildly or severely affect motor function. The syndrome may produce hemiplegia, paraplegia, quadriplegia, or diplegia.

Affected limbs usually are underdeveloped and show increased deep tendon reflexes, weakness, and a tendency toward contractures. A scissors gait and toe walking are characteristic. In mildly affected children, impairment may occur only during certain activities (eg, running). With quadriplegia, an associated impairment of oral, lingual, and palatal movement, with consequent dysarthria, is common.

Athetoid Cerebral Palsy - occurs in about 20% of cases. Slow, writhing, involuntary movements may affect the extremities (athetoid) or the proximal parts of the limbs and the trunk (dystonia); abrupt, jerky, distal movements (choreiform) also may occur. The movements increase with emotional tension and disappear during sleep. Dysarthria occurs and is often severe.

Ataxic Cerebral Palsy - occurs in about 10% of cases. Weakness, incoordination, and intention tremor produce unsteadiness, a wide-based gait, and difficulty with rapid or fine movements.

Mixed CP - is not uncommon, and is a combination of the above types but is most often a mixture of spasticity and athetoid movements, with tight muscle tone and involuntary reflex.

Symptoms of cerebral palsy may be evident immediately after birth, or may take months or years (1,200 - 1,500 preschool children are diagnosed each year), to become noticeable. Parents may notice that their child is slow to reach developmental milestones or displays abnormal behavior.

• At 3 months there may be a lack of facial expressions, the baby may not respond to some sounds, or is unable to follow movement with their eyes.
• The child may not be able to bring their hands together at 4 months.
• A child with cerebral palsy may not display the coordination to lift their head, or rollover at 6 months.
• At 8 months the baby may not be able to sit up by themselves, or without support. There may be a head lag when the child is placed in a sitting position.
• By 12 months the child may not be able to crawl.
• Drooling is a common problem because of the lack of facial and muscle control.
• Muscle tremor or spasticity may be evident, with a tendency of infants to tuck their arms in toward their sides, scissors movements of the legs, or other abnormal movements.
• Feeding may be a continuous effort and problematic.
• Excessive stiffness when dressing, changing diapers, or bathing.

It is important to realize that the presence of any of these symptoms does not necessarily indicate your child has cerebral palsy. Children develop on different timeframes, and symptoms are often outgrown. Only your doctor can make an accurate diagnosis and provide you with the information you need to care for your child.

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