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Cerebral palsy affects both the brain and body parts. Brain issues depend on the type of brain injury or abnormality that develops, while affected body parts depend on the severity of the disorder, as well as the type of cerebral palsy the child has. Brain issues lead to affected body parts, making movements, swallowing, daily activities, and eye coordination difficult.
Cerebral Palsy and the Brain
Cerebral palsy is generally caused by damage to parts of the brain, specifically, the parts of the brain that control movement.[1] The following types of brain damage can lead to developmental issues, movement problems, and issues with swallowing, hearing, and eye movement.
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Damage to the brain’s white matter, known as periventricular leukomalacia (PVL), appears as small holes in the baby’s white matter of the brain. PVL can affect movement, tighten muscles, and cause vision problems. PVL can also be associated with developmental delays.[2]
Intracranial Hemorrhage
Bleeding in the brain, known as an intracranial hemorrhage, happens when broken or blocked blood vessels cause a fetal stroke. Intracranial hemorrhaging is considered dangerous, and medical assistance is needed as soon as possible.
The severity of intracranial hemorrhage will depend on how much bleeding has happened and how much of the brain tissue has been affected. A grading system consisting of Grade I through IV is generally used to determine the seriousness of the hemorrhage.
Seizures are also associated with intracranial hemorrhage.
Asphyxia
Asphyxia is the lack of oxygen to the brain. This can happen while the baby is still in utero and during childbirth.
Loss of oxygen for prolonged periods can lead to hypoxic-ischemic encephalopathy, a medical issue marked by damaged cerebral motor cortex tissue and damaged tissue in and other areas of the brain.
Body Parts Affected by Cerebral Palsy
As previously mentioned, the body parts affected by cerebral palsy will depend on the severity and the type of the disorder.
Quadriplegia
All four limbs are affected when children have quadriplegic cerebral palsy, also known as spastic quadriplegia. It’s a subset of spastic cerebral palsy and the most severe form of the disorder.
Children with quadriplegic cerebral palsy may have mouth issues and difficulties with swallowing.[3] They could also have problems dealing with bowel and bladder control.
In severe cases, children with quadriplegic cerebral palsy cannot walk or talk and may develop limb deformities.
Spastic Diplegia
Diplegia, also known as spastic diplegia, is a subset of spastic cerebral palsy marked by issues in the limbs, specifically in the legs. Spasticity in the legs leads to stiff, jerky movements and hypertonia.
According to the U.S. Department of Health and Human Services, along with muscle weakness and stiffness in the limbs, children with spastic diplegia tend to walk on their toes. They can also have problems with their eyes crossing, balance issues, and delayed milestones.[4]
Due to stiff and tight muscles, some children with spastic diplegia walk with a scissor gate. In a scissor gate, the legs turn inward, and the knees close together or crossed. In extreme cases, children may not be able to walk.
Although the legs are more likely to have issues, some children with spastic diplegia will also have issues with their upper body parts, depending on the severity of the disorder. Arms can become spastic and stiff.
With mild spastic diplegia, children can typically have good muscle tone and a good range of motion.
Spastic Hemiplegia
Spastic hemiplegia is a subset of spastic cerebral palsy that affects one side of the body.
According to the Centers for Disease Control and Prevention (CDC), spastic hemiplegia generally causes muscle stiffness and spasticity in one arm and hand. Still, it can sometimes affect the leg on the same side.[5]
Muscle stiffness on the affected side can cause children to have a clenched fist and walk on their toes.
Children with spastic hemiplegia sometimes develop scoliosis (a spine curvature). Further, the affected arm and leg may be shorter than the unaffected limbs.
Children with spastic hemiplegia have a high risk of seizures and oral motor difficulties.
Dyskinetic Cerebral Palsy
Dyskinetic cerebral palsy includes the subtypes athetoid, choreoathetoid, and dystonic. This form of cerebral palsy affects the arms, feet, hands, and legs.
Children with dyskinetic cerebral palsy may exhibit writhing, slow movements, along with jerky movements in the affected limbs. [6] Involuntary limb movements are also common and generally happen more frequently when the child is anxious, stressed, or tired.
Some children with dyskinetic cerebral palsy only have affected limbs on one side of the body, whereas others will experience it in all limbs. Others may have issues with the neck muscles and involuntary neck twisting or tilting.
Oral issues are also common in children with dyskinetic cerebral palsy, affecting both speech and swallowing.
Ataxic Cerebral Palsy
Ataxic cerebral palsy can affect any part of the child’s body. For instance, ataxic CP can affect the eyes, mouth, arms, fingers, legs, and toes. Children with ataxic cerebral palsy have tremors in shakiness in their limbs due to inaccurate movements.[7]
Children with ataxic cerebral palsy are prone to falling due to shakiness in the lower limbs. They often walk with their legs spread further apart than usual.
Ataxic cerebral palsy affects the mouth, which can cause difficulties in swallowing and the possibility of scanning speech. Speech problems are marked by a monotone voice tone and unusual pauses between speech syllables.
Eye movements can be abnormal for children with ataxic CP. If a child moves their eye gaze quickly, they may miss their intended target. Eye issues also cause problems when reaching to grasp objects.
Mixed Cerebral Palsy
Children with mixed cerebral palsy have a combination of issues from the different types of the disorder.
The National Institute of Neurological Strokes and Disorders reports that children with mixed cerebral palsy “don’t correspond to any single type of CP but are a mix of types.”
Cerebral palsy is a neurological condition that causes numerous and varied symptoms and associated conditions. It is a lifelong condition that requires ongoing treatment. If your child was born with cerebral palsy, talk to a lawyer about your rights.
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- Cerebral palsy: Hope through research. (2020, March 30). National Institute of Neurological Disorders and Stroke | National Institute of Neurological Disorders and Stroke.
Retrieved from: https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Hope-Through-Research/Cerebral-Palsy-Hope-Through-Research - Periventricular Leukomalacia. (n.d.). Boston Children's Hospital.
Retrieved from: https://www.childrenshospital.org/conditions/periventricular-leukomalacia - Effects of oral motor therapy in children with cerebral palsy. (2013). U.S. National Institutes of Health. PubMed Central (PMC).
Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3788277/ - Spastic diplegia cerebral palsy. (2018, August 7). Genetic and Rare Diseases Information Center (GARD) – an NCATS Program | Providing information about rare or genetic diseases.
Retrieved from: https://rarediseases.info.nih.gov/diseases/9637/spastic-diplegia-cerebral-palsy - What is cerebral palsy? (2020, June 3). Centers for Disease Control and Prevention.
Retrieved from: https://www.cdc.gov/ncbddd/cp/facts.html - The early markers for later dyskinetic cerebral palsy are different from those for spastic cerebral palsy. (2002). Journal of Pediatric Neurobiology, Neurology and Neurogenetics.
Retrieved from: https://www.researchgate.net/profile/Anastasia_Dressler/publication/11298511_The_Early_Markers_for_Later_Dyskinetic_Cerebral_Palsy_are_Different_from_Those_for_Spastic_Cerebral_Palsy/links/02e7e51642b164e913000000.pdf - Cerebral palsy ataxic. (2020, November 1). Genetic and Rare Diseases Information Center (GARD) – an NCATS Program | Providing information about rare or genetic diseases.
Retrieved from: https://rarediseases.info.nih.gov/diseases/10451/cerebral-palsy-ataxic