Atonic Cerebral Palsy (Hypotonic)

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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 significantly improve their quality of life.

About Atonic Cerebral Palsy

Atnoia means a lack of tone in the muscles. Children with this type of cerebral palsy have difficulty moving and have poor reflexes.

Today, the main types of cerebral palsy are spastic, dyskinetic, ataxic, and mixed.[1] Atonic cerebral palsy is 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 causes that occur during labor include damage to the placenta, fetal stroke, and maternal high blood pressure (which can lead to fetal stroke).

Lesions caused by infections and cytokines released while the mother is pregnant, usually during the first five months of pregnancy, can also cause atonic cerebral palsy.[2]

Atonic Cerebral Palsy Symptoms

An early sign of atonia is little to no head control. Physicians usually detect a problem when a baby isn’t holding its head up by three months. Other symptoms of atonic cerebral palsy include: 

• 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, there is currently no known cure for cerebral palsy. However, several treatment options can help your baby.

A team of medical professionals consisting of therapists, pediatricians, and other healthcare professionals typically work together to develop a solid treatment plan.

Botox 

Botox 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.”[3]

Scientists and physicians who conducted the study also stated that some children’s muscles stopped responding to the treatment. Talk with your physician about this form of treatment and carefully weigh out the pros and cons before deciding.

Keep in mind that the use of Botox for cerebral palsy treatment is considered off-label use. The FDA has not approved it for this use. 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

Physical therapy is “widely accepted as a component of standard management” for cerebral palsy, according to the NIH.

The benefits of physical therapy include:

• Improved coordination
• Balance
• Strength
• Endurance
• Pain management
• Overall health

Occupational therapy

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.”[4]

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.[5]

Medication

Medications for seizures, pain, and other health issues help ease pain and manage symptoms.

Speech Therapy

According to the NIH, more research is needed to determine if speech therapy is effective for children with atonic cerebral palsy. 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 favorable prognosis. However, the prognosis greatly depends on the severity of the disorder and the accompanying health issues, and 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.”[6]

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.