Dyskinetic cerebral palsy, also known as athetoid cerebral palsy or ADCP, is a form of the disorder marked by involuntary movement. Though not as common as spastic cerebral palsy, it’s not as rare as ataxic or mixed CP.
What Causes Dyskinetic Cerebral Palsy?
Dyskinetic/Athetoid cerebral palsy is caused by damage to the brain’s basal ganglia. The basal ganglia is responsible for submitting messages to the body to help coordinate and control movements. When it’s damaged, voluntary movements are compromised, resulting in involuntary and abnormal movements.
Characteristics and Symptoms of Dyskinetic Cerebral Palsy
There are three defining characteristics of dyskinetic cerebral palsy: dystonia, athetosis, and chorea. Each of these characteristics come with their own symptoms.
Dystonia involves involuntary muscle contractions that are marked by writhing, slow and repetitive movements that become worse when the child begins to move
Other symptoms include:
- Abnormal and awkward posture
- Movements that alternate from slow and painful to fast and rapid
- Involuntary movements that increase when the child is stressed or tired
Dystonia can affect all parts of the body, but in some cases, it’s localized in only one area of the body. For example, while one child may have involuntary, awkward movements in the entire body (generalized dystonia), another child may have these same symptoms only in the legs (focal dystonia).
Sensory tricks is a way many people with dystonia can help suppress involuntary movements. For example, resting against the wall or placing their hand behind the head can help some people with dystonia control the movements. Other sensory tricks include pressing fingers against the eyes or nose, using a tight headband on the forehead, and placing the hand under the chin.
Athetosis is another characteristic of dyskinetic cerebral palsy, marked by slow twitching and wriggling movements. The symptoms can surface while resting and generally become worse when the child moves.
Other common symptoms of athetosis include:
- Involuntary slow, continuous writhing movements which worsen with attempts to move
- Fluctuating muscle tone (from stiff to floppy)
- Grimacing and/or drooling from lack of facial muscle control
- Difficulties with eating and drinking
- Difficulties grasping and holding small objects because of changes in muscle tone
- Involuntary movements may be continuous unless the child is totally relaxed
- Involuntary movements typically disappear when the child is asleep
Chorea is a characteristic of dyskinetic cerebral palsy marked by brief irregular and involuntary movements. The name was derived from the Greek word, chorea, meaning “dance,” since the involuntary movements are often repetitive. This can affect multiple parts of the body.
Chorea can result in difficulties with chewing, drinking, swallowing, and speech.
Treatment Options for Dyskinetic/Athetoid Cerebral Palsy
Physical therapy is generally one of the first types of treatment advised for people with dyskinetic forms of cerebral palsy. Physical therapy should be initiated as soon as possible, and once a child reaches school age, it may be incorporated into the daily schedule at school, along with weekly treatment sessions at a designated physical therapy center, doctor’s office, or at home with a licensed physical therapist.
Since children with dyskinetic/athetoid cerebral palsy often have problems with communication, speech therapy usually accompanies physical therapy. Speech therapy, also known as speech and language therapy, helps children learn to communicate more effectively. It also assists with breathing and chewing problems by helping patients learn techniques through frequent practice.
Medication may also be prescribed to children with athetoid/dyskinetic cerebral palsy. Since involuntary muscle movements are some of the primary symptoms, medications such as anticholinergics are often prescribed to help control muscle spasms, and pain as these types of drugs block off chemical messengers in the brain.
Other medications that may be prescribed for athetoid cerebral palsy include muscle relaxants, medicines for sleep problems, and gastric reflux medicines.
If oral medication doesn’t work, other treatment options may include a baclofen pump, in which a small pump is implanted in the child’s abdominal wall. The pump then disperses baclofen to the child’s central nervous system in regular increments.
In some instances, orthopedic surgery is recommended in order to correct limb deformities such as contractures. Surgery is generally reserved for children who have marked deformaties or continue to experience pain when walking and moving.
Dyskinetic/Athetoid Cerebral Palsy Prognosis
The long-term outlook for children with dyskinetic cerebral palsy will depend upon the severity of the brain damage and how well treatment works. For instance, this type of cerebral palsy can range from minor to severe. Children with minor symptoms may respond well to treatment and lead an independent life, whereas those with more severe cases of the disorder will need in-depth, long-term, and ongoing medical care.