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Dystonic cerebral palsy, also referred to as dystonia, causes involuntary muscle contractions and movements that affect either one part of the body or the entire body. Dystonic CP is a form of dyskinetic cerebral palsy. There is no cure for it, but many treatment options are available, including sensory tricks that can help control the symptoms.
What is Dystonic Cerebral Palsy?
According to the American Academy of Cerebral Palsy and Developmental Medicine, dystonic cerebral palsy is a movement that causes increased muscle tone and uncontrollable, involuntary posture and movement.
Children with dystonia have repetitive, twisting movements caused by muscle contractions. Dystonia is a form of dyskinetic cerebral palsy, which is also marked by uncontrollable movements and muscle contractions.
Dystonic cerebral palsy often interferes with the child’s sleep due to uncomfortable pain caused by contractions. It can also be difficult for children with dystonia to sit or lie down.
Further, the involuntary movement contributes to the child expending a lot of energy, which can tire them easily.
Some children with dystonic cerebral have difficulties chewing and swallowing, which could lead to malnutrition.
Symptoms of Dystonic Cerebral Palsy
Along with uncontrollable and repetitive movements, children with dystonic cerebral palsy could also exhibit the following:
- Movement that switches between rapid and slow
- Painful movements
- An increase in uncontrollable movements if the child is tired or anxious
- Affected speech patterns due to uncontrollable movements in the jaw and mouth
- Trouble with walking
- One leg that drags
- Foot cramps
- Uncontrolled blinking
- Speech and eating issues
For young children with dystonic cerebral palsy, symptoms generally first appear in a hand or foot. Over time, the symptoms can expand to other parts of the body. By the time the child reaches the teen years, the progression of the symptoms tends to slow down.
How Does Dystonic Cerebral Palsy Affect the Body?
Dystonic cerebral palsy can be subdivided by the areas of the body it affects:
- Many children experience dystonia on one side of the body. This is known as focal dystonia, which can affect both legs and one arm or the trunk of the body, along with one leg and one arm.
- Other children have issues with their entire bodies, known as generalized dystonia. Children with generalized dystonia usually have a difficult time with walking and balance. Generalized dystonia can also occur in the hand and upper body, making movements tight and painful and causing fatigue.
- Dystonia can also occur in the head, neck, and shoulders, making for abnormal twists and turns. This is known as cervical dystonia.
- Oromandibular dystonia occurs when the child’s mouth, jaw, and tongue are affected. Some children are susceptible to malnutrition and dietary issues.
- Hemidystonia affects one arm and leg on the same side of the body.
Symptoms of dystonic cerebral palsy are present sometimes, but not with all activities. For example, a child may have issues while walking but not when swimming. Keep in mind that not all children exhibit the same symptoms.
Dystonic Cerebral Palsy and Sensory Tricks
According to “Current Clinical Neurology,” a sensory trick occurs when a child touches a certain part of their body, such as their chin, which can “neutralize involuntary head movements.”
Further, placing a finger near the dystonic area and raising a hand may release the dystonia. Others find help by touching an eyelid.
According to the U.S. National Institutes of Health, the sensory tricks are trial and error, and while one trick may work for one child, it may not work for everyone.
“Sensory tricks vary from person-to-person and within the same individual. The multiple and heterogenous features was were misinterpreted as indicative of a psychogenic etiology.”
Dystonic Cerebral Palsy Causes
The National Institute of Neurological Disorders and Stroke reports that sometimes dystonia causes are not known. In other cases, dystonia is a genetic condition.
Low birth weight, problems with the placenta, and premature birth are associated with dystonia.
Also, physical trauma during birth can result in dystonia. This occurs when a baby is deprived of oxygen during childbirth or when a doctor applies excessive force during delivery.
For example, a newborn with jaundice will typically have excess bilirubin in their blood. Untreated jaundice that is high can lead to basal ganglia damage in the brain, known as kernicterus. In kernicterus, the basal ganglia are stained with bilirubin. This type of brain damage can result in cerebral palsy.
For children with dystonic cerebral palsy, damage typically occurs in the brain’s upper motor neurons.
As mentioned earlier, the primary cause of dystonic cerebral palsy is injuries to parts of the basal ganglia, particularly the area of the brain that controls movement. The basal ganglia are a group of subcortical nuclei in the brain that control motor function, learning, and behavior.
Dystonic Cerebral Palsy Treatment
Although there is currently no known cure for dystonic cerebral palsy, there are a number of treatment plans available that can optimize your child’s care.
Your child’s pediatrician can work with you to develop a treatment plan which usually involves a team of caregivers, such as therapists, support groups, educational specialists, who will work together to build an individualized treatment plan.
Medications can treat dystonic cerebral palsy. Oral baclofen is generally the first medication used. It can help with pain and sleeping issues.
If baclofen isn’t successful, doctors may try other medications, such as trihexyphenidyl or benzodiazepines.
Intrathecal baclofen (ITB) or deep brain stimulation (DBS) can also be used, at the discretion of the child’s doctor and specialist, to help with severe cases of pain and discomfort.
Doctors almost always recommend a team of therapists to address a child’s overall treatment plan. Physical therapists, occupational therapists, and speech pathologists can all assist in helping the child with movements, day-to-to activities, and communication.
It’s always a good idea to consult with your child’s pediatrician if you have any concerns with your child’s treatment plan.
If you have questions or need additional assistance, feel free to contact us at 866-579-8495.
- AACPDM - American Academy for Cerebral Palsy and Developmental Medicine. (2018). Dystonia in Cerebral Palsy.
Retrieved from: https://www.aacpdm.org/publications/care-pathways/dystonia-in-cerebral-palsy
- Pediatric dystonia. (2018, November 9). Dystonia Medical Research Foundation.
Retrieved from: https://dystonia-foundation.org/what-is-dystonia/types-dystonia/pediatric-dystonia/#:~:text=Dystonia%20in%20childhood%20is%20a,chronic%20or%20occur%20in%20episodes.
- Dystonias fact sheet. (2020, March 13). 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/Fact-Sheets/Dystonias-Fact-Sheet
- Cervical dystonia: Sensory tricks. (n.d.). SpringerLink. Current Clinical Neurology book series (CCNEU)
Retrieved from: https://link.springer.com/chapter/10.1007%2F978-1-60327-426-5_43
- Tricks in dystonia: Ordering the complexity. (2014, January 13). U.S. National Institutes of Health. PubMed Central (PMC).
Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4747630/
- Treating complex movement disorders in children with cerebral palsy. (n.d.). U.S. National Institutes of Health. PubMed Central (PMC).
Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2773587/