Cerebral palsy is a neurological disorder with severe motor and coordination impairments. The signs or symptoms of cerebral palsy may appear soon after birth or may take several months to become apparent.
Cerebral palsy is classified into different types depending on the type of symptoms. These symptom-based classifications further indicate the parts of the brain that is affected with the condition.
Spastic cerebral palsy
This affects 70 to 80% of all children with cerebral palsy. In this condition some of the muscles in the body are tight and stiff with increased muscle tone. The limbs in addition are weak and are drawn in due to increased tone. This makes control of movements difficult.
Due to increased muscle tone the child may appear initially to be walking on toes. If the upper limbs are affected there may be tight fisting of deformities in normal posture of the hand.
People with spastic diplegia might have difficulty walking. This is because tight hip and leg muscles cause their legs to pull together, turn inward, and cross at the knees (also known as scissoring).
Athetoid (dyskinetic) cerebral palsy
This affects around 10% of children with epilepsy. In this type there may be spontaneous and unwanted irregular writhing movements. This hinders control of movements.
The muscles change rapidly from being hypertonic or increased tone to hypotonic or becoming floppy and loose. The muscles used for speech may also be affected. Posture is also affected in most cases.
Ataxic cerebral palsy
There may be shaky movements and difficulty in maintaining balance and coordination. There is shakiness of hands and feet and difficulty with speech
Mixed cerebral palsy
This has combined features of other types of cerebral palsy.
Other symptoms of cerebral palsy
Other symptoms of cerebral palsy include:
- Feeding problems – this occurs due to lack of coordination of muscles of the mouth. These problems mean difficulty in chewing and swallowing food in a coordinated manner. Feeding may be slow with gagging and vomiting.
- Delayed developmental milestones – the growth in the child with sitting up, crawling and walking at appropriate ages is disrupted. There may be weakness or paralysis of the limbs. The child may walk with an abnormal gait. There may be slow development of speech and social abilities.
- Epilepsy and seizures – around one third of children with cerebral palsy also have epilepsy.
- Problems with fine motor skills - difficulty with writing, eating, talking, dressing and performing finer activities with fingers.
- Problems with balance and coordination with frequent falls.
- Difficulty controlling and maintaining posture. These individuals may need support or devices to stay upright.
- Learning difficulties – some individuals with cerebral palsy may have moderate to severe mental retardation and may have learning difficulties.
- Hearing problems.
- Vision problems and blindness. There may be squint or strabismus as well.
- Urinary incontinence of bladder incontinence. Individuals with cerebral palsy may have delayed toilet training or in severe cases may have a lack of control over their bladder evacuation and urination.
- Constipation – this is a common problem that results from poor mobility and poor oral intake.
- Sleep problems – these affect as many as 50% of individuals with cerebral palsy.
- Drooling – this constant dripping of saliva from the corners of the moth indicates lack of facial muscle control and may result from pseudobulbar palsy.
- Orthopaedic problems – there may be fractures due to osteoporosis, osteomalacia and low bone mineral density. There may be bone contractures due to increased muscle tone. This leads to drawing up of the limbs, shortened muscles, hip or foot deformities, scoliosis or spine deformities etc.
Reviewed by April Cashin-Garbutt, BA Hons (Cantab)