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Atonic cerebral palsy, also referred to as hypotonic cerebral palsy or ataxic–hypotonic CP, is a rare form of the disorder that affects various muscle groups and movements. It can also have accompanying conditions, such as seizures and vision impairment. Numerous treatment methods are available for children with atonic CP, which can greatly improve their quality of life.
About Atonic Cerebral Palsy
According to the Official Journal of the American Academy of Pediatrics (AAP), atonic cerebral palsy was first considered a “symptom” of a type of cerebral palsy.  It stands for atonia, meaning a lack of tone in the muscles.
Later, AAP accepted a “motor classification, listing each type of cerebral palsy separately: Spastic, Athetoid, Tremor, Rigidity, Ataxic, Atonic, and Mixed.”
The main types of cerebral palsy, however, are considered spastic, dyskinetic, ataxic, and mixed. 
Atonic cerebral palsy is considered rare, making it difficult for doctors to get an accurate diagnosis.
What Causes Atonic Cerebral Palsy?
Atonic cerebral palsy develops after an infant experiences damages to the cerebellum, which is the part of the brain that controls balance and coordination. Difficult labor is one of the primary reasons atonic cerebral palsy can occur if it leads to loss of oxygen and brain damage.
For instance, oxygen deprivation can happen at any stage during pregnancy, but it most often occurs when a baby becomes distressed during labor. A baby that’s lodged in the mother’s pelvis can experience oxygen loss, as well as an infant with a compressed or twisted umbilical cord.
Other issues during labor that can lead to cerebral palsy include damage to the placenta, fetal stroke, and maternal high blood pressure (which can lead to fetal stroke).
Lesions caused by infections and cytokines that are released while the mother is pregnant, usually during the first five months of pregnancy, can also cause atonic cerebral palsy. 
Atonic Cerebral Palsy Symptoms
- Little to no head control: Physicians usually detect a problem when a baby still isn’t holding their head by three months of age.
- Slow reflexes
- Awkward, unsteady movements and poor balance
- A wide gait, with feet unusually far apart
- Low muscle tone
- Learning disabilities and speech impediments (which accounts for around 50% of children with atonic cerebral palsy)
- Slow eye movements
- Breathy or grunting sounds
- Difficulties with writing, buttoning shirts and eating
- Some children with atonic cerebral will experience seizures
- Breathing difficulties
- Ligament and joint laxity
Atonic Cerebral Palsy Treatment
As with all forms and types of cerebral palsy, there is currently no known cure. However, there are a number of treatment options that can help your baby. A team of medical professionals consisting of therapists, pediatricians, and other healthcare professionals typically work together to come up with a solid treatment plan.
Botox and related short-term treatment medications can help stiffen the muscles and control muscle tremors. However, a study published by the U.S. National Institutes of Health (NIH) warns that “most studies have shown that the improvements following BoNT-A therapy in children for spastic equinus are small and short-lived.” 
Scientists and physicians who conducted the study also stated that some children’s muscles stop responding to the treatment. Talk with your physician about this form of treatment and carefully weigh out the pros and cons before making a decision.
Keep in mind that the use of Botox for cerebral palsy treatment is considered off-label use and has not been approved by the FDA. However, the potential benefits of Botox for cerebral palsy include:
- Gait pattern improvement
- A decrease in pain
- Spasticity reduction
- Range of motion improvement
- Positioning improvement
Physical therapy is “widely accepted as a component of standard management” for cerebral palsy, according to NIH.
The benefits of physical therapy include improved coordination, balance, and strength. It can also help with endurance, pain management, and overall health.
Occupational therapy can assist a child with their daily living skills, including eating, writing, bathing, and dressing. Occupational therapists work with helping children’s small muscles and posture.
According to research published by the American Academy of Pediatrics, a study confirmed that children with cerebral palsy who participated in an occupational therapy home program “produced statistically significant differences in function and parent satisfaction with function, compared with no OTHP.” 
Stem cell therapy
The U.S. National Institutes of Health reports that stem cell therapy used in connection with children with atonic cerebral palsy shows promising results.
“Our data shows that about 73% of patients with CP may benefit from this treatment. The improvement ranges from 0 to 3 score levels averaging 1.3 points. There is also a good degree of cognitive, functional, and bladder and bowel control as well as improvement of the spasticity,” the report read. 
Medications for seizures, pain, and other health issues are often prescribed to help ease pain and manage symptoms.
More research is needed to determine if speech therapy is effective for children with atonic cerebral palsy, according to NIH. However, it depends on the severity of the child’s condition. Children with severe cognitive dysfunction may not show as much progress as a child with normal cognitive function or slight issues with cognitive abilities.
Atonic Cerebral Palsy Prognosis
With a team of medical professionals and prompt treatment, most children with atonic with cerebral palsy have a positive prognosis. However, the prognosis greatly depends on the severity of the disorder and the accompanying health issues, as well as when the child is diagnosed.
According to Dr. Ananya Mandal, MD, “life span may be shortened” for children with severe cerebral palsy who don’t have proper management of the disorder. Further, conditions such as seizures, feeding difficulties, vision issues, and hearing problems can “severely affect life span and quality of life.” 
Other factors that can reduce lifespan include:
- The severity of the child’s impairments
- Intellectual disabilities and cognitive functioning
- The severity of respiratory issues
- The level of overall severity of the child’s disorder
- Mobility issues, which can cause a weakened immune system and premature aging
Keep in mind, however, high-quality medical care combined with aggressive treatment can help your child tremendously. It’s important to speak with your child’s physician and figure the best course of treatment and proper therapies for the best chances of a long lifespan.
- Minear, M.D., Ph.D, W. L. (n.d.). A classification of cerebral palsy. American Academy of Pediatrics.
Retrieved from: https://pediatrics.aappublications.org/content/pediatrics/18/5/841.full.pdf?download=true
- 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
- Causes and risk factors of cerebral palsy. (2019, September 23). Centers for Disease Control and Prevention.
Retrieved from: https://www.cdc.gov/ncbddd/cp/causes.html
- Botulinum toxin in the management of children with cerebral palsy. (n.d.). PubMed Central (PMC).
Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6682585/
- Novak, I., Cusick, A., & Lannin, N. (2009, September 21). Occupational therapy home programs for cerebral palsy: Double-blind, randomized, controlled trial. National Center for Biotechnology Information, National Library of Medicine.
Retrieved from: https://pubmed.ncbi.nlm.nih.gov/19770175/
- Treatment of cerebral palsy with stem cells: A report of 17 cases. (2016, May 9). PubMed Central (PMC), US National Library of Medicine, National Institutes of Health.
Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4961108/
- Mandal M.D., A. (2019, February 26). Cerebral palsy prognosis. News Medical Life Sciences.
Retrieved from: https://www.news-medical.net/health/Cerebral-Palsy-Prognosis.aspx