Mixed Cerebral Palsy
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There are various types of cerebral palsy, each with its own set of symptoms. Sometimes children show signs and symptoms of more than one form of CP, which is known as mixed cerebral palsy.
According to the Centers for Disease Control and Prevention (CDC), there are three types of recognized forms of cerebral palsy. If a child exhibits symptoms from at least two forms, they have mixed cerebral palsy. Mixed CP accounts for around 10% of all people diagnosed with the disorder.
Cerebral Palsy Types and Symptoms
The three primary forms of cerebral palsy include ataxic, dyskinetic, and spastic. Take a look at the symptoms of each type to get a better understanding of the symptoms and causes associated with mixed cerebral palsy.
Dyskinetic cerebral palsy is typically caused by injuries and damage to certain parts of the brain. In a majority of cases cerebral palsy is congenital and a cause is not known.It can also occur from diseases such as meningitis, or birth injuries, and lack of oxygen.
Dyskinetic CP is marked by symptoms that fluctuate between stiff, rigid movements to loose, floppy movements. The variation of movements is caused by the child’s inability to control muscle tone. Fluctuations can occur from day to day.
Children with dyskinetic CP typically have issues with walking, balance, coordination, tremors, and grasping objects. They have problems with controlling their arms, hands, feet, and legs. Movement is often uncontrollable and can range from slow to rapid and jerky. Young children can have problems with tongue control that can lead to feeding problems.
Dyskinetic CP includes subtypes which include athetoid, choreoathetoid, and dystonic.
Ataxic cerebral palsy is generally caused by a brain injury that happens before, during, or after birth. It involves damage to the cerebellum, which is a part of the brain that controls motor function. Cerebellum injuries can happen while a baby is still in the mother’s womb or through fetal stroke or head injuries.
Ataxic CP is marked by symptoms such as poor motor skills, issues with walking, shaking, tremors, balance, and depth perception problems. Ataxic CP is a rare form of the disorder and accounts for around 5% to 10% of all diagnosed cases.
Spastic cerebral palsy is the most common form of the disorder. It accounts for around 70% of all people diagnosed with CP. Similar to other types of cerebral palsy, a definitive cause is never found, but spastic CP can be caused by brain injuries. Specifically, when the brain’s motor cortex and pyramidal tracts are damaged, spastic CP can develop.
Brain injuries can happen before, during, and after birth, due to fetal infection, prenatal brain hemorrhage, or lack of oxygen.
Typical symptoms of spastic cerebral palsy include stiff muscles (on either one side or both sides of the body), abnormal reflexes and gait, distorted movements, and contracture. Some children will have crossed knees, while some may walk on their tiptoes.
What Happens When a Child Has Mixed Cerebral Palsy
Depending on which forms of cerebral palsy develops, a child with mixed CP can have all of the symptoms mentioned above, or sometimes a few. Mixed cerebral palsy doesn’t “correspond to any single type of CP but are a mix of types,” according to the National Institutes of Health.
For instance, a child with both spastic and ataxic CP could have issues with distorted movements, as well as depth perception issues. A child with spastic CP and athetoid CP could have problems with grasping objects and unnatural reflexes.
Spastic and athetoid CP are the most common types of mixed cerebral palsy, although a mixture of any types can happen. Doctors usually diagnose spasticity first, followed by other types of the disorder.
Problems with Mixed Cerebral Palsy
Children with any form of cerebral palsy will likely face medical issues specific to each type. A child with mixed cerebral palsy could face specific medical problems of two or three types of cerebral palsy, which makes treatment more difficult.
For example, a child with the spastic quadriplegia form of spastic cerebral palsy is at risk of brain malformations. A child with ataxic CP will have issues grabbing objects and buttoning shirts. A child with both spastic and ataxic is at risk of developing brain malformations and grasping issues.
Children with mixed cerebral palsy are also at risk of developing seizures, which can range from mild to severe. They also may have issues with swallowing, which could put them at risk for malnutrition. Further, children with mixed CP are at risk of developing intellectual disabilities, which can also range from mild to severe.
Mixed Cerebral Palsy Causes
As previously mentioned, all forms of cerebral palsy develop due to atypical brain development or brain damage. Mixed cerebral palsy develops the same way, but the way brain damage or abnormal brain development can vary.
In some instances, a maternal infection can cause brain damage. In other cases, fetal infections can cause brain damage. Maternal or fetal infections are one of the causes of infant brain damage. Infants with low birth weight are a heightened risk of developing brain deformity and/or brain damage, which can lead to cerebral palsy.
Oxygen deprivation before, during, and after birth can happen for many reasons. If a baby is in distress during maternal labor, medical professionals must act fast to ensure the baby is delivered as healthy as possible.
For example, if a baby is in a breech position and the doctor cannot pull them out, a C-section could become necessary. Delays in starting a C-section could lead to oxygen deprivation. Decreased oxygen supply could lead to devastating results for the baby.
Issues with the umbilical cord and the placenta can lead to oxygen loss, which in turn can lead to cerebral palsy.
Mixed Cerebral Palsy Treatment
Treatment for mixed cerebral palsy will depend on what types and symptoms of CP the child develops. The most common examples of treatment include:
- Physical therapy
- Occupational therapy
- Recreations therapy
- Complementary and alternative treatment
- Speech therapy
- Medical Marijuana (where legally available)
- Assistive devices, such as wheelchairs and walkers
For specific details on the types of treatment options available for children with cerebral palsy, visit our page, Cerebral Palsy Treatment.
There are numerous symptoms a child with mixed cerebral palsy can develop, depending upon the severity of the disorders and the types of CP the child has. Additional symptoms can include:
- Issues with social interaction and emotional health
- Pain, weakness, and fatigue
- Hearing loss and vision problems
- Delayed growth
- Impaired vision
- Learning disabilities
- Dental issues
- Spinal deformities
Keep in mind that each child is different. While one child may have numerous CP symptoms, another child may only develop a few.
For more information on cerebral palsy symptoms, refer to our article Cerebral Palsy Symptoms.