Non-Spastic Cerebral Palsy

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Non-spastic cerebral palsy, also known as extrapyramidal cerebral palsy, accounts for around 20% of all cases of CP in the United States.

What is Non-Spastic Cerebral Palsy?

Non-spastic cerebral palsy causes decreased muscle tone that tends to fluctuate.[1] There are two major types of non-spastic cerebral palsy, with some sub-types, and each one has its own set of characteristics. However, all forms of non-spastic cerebral palsy will have muscle tone variations that go from floppy to stiff.[2]

Dyskinetic Cerebral Palsy

Dyskinetic cerebral palsy is a form of non-spastic cerebral palsy that’s separated into sub-groups: athetosis (see below for more information), dystonia, and chorea.[3]

Symptoms of athetosis include:

• Involuntary slow, “stormy” movements
• Arms, feet, hands, and legs may have writhing movements
• Fluctuating muscle tone (from stiff to floppy)
• Facial grimacing and drooling from poor control of facial muscles
• Difficulty eating and drinking due to poor coordination of swallowing muscles
• Difficulty grasping and holding small objects due to changing muscle tone
• Involuntary movements may be continuous unless the child is totally relaxed
• Involuntary movements typically disappear when the child is asleep

Symptoms of dystonia include:

• Abnormal and awkward posture
• Repetitive, twisting, or jerky movements
• Movements that alternate from slow and painful to fast and rapid
• Involuntary movements
• Muscle spasms and involuntary movements that increase when the child is stressed or tired
• Dystonia may affect only one part of the body or all of the body

Symptoms of chorea include:

• Abrupt, fidgety movements
• Unpredictable movements
• May appear uncoordinated or clumsy

Ataxic Cerebral Palsy

Ataxic cerebral palsy is another form of non-spastic cerebral palsy and is also the rarest type of the disorder, accounting for less than 10% of all cases.[4]

Ataxic cerebral palsy comes with its own set of distinct characteristics and symptoms, which may include:[5]

• Problems with balance, depth perception, and coordination
• Difficulty walking
• Tremors (especially when reaching for things)
• Difficulty making quick movements
• Difficulty with precise finger movements, such as writing
• Breathy sounds and monotone voice when speaking, known as “scanning” speech
• Slow eye movements
• Hearing and vision problems

Treatment Options for Non-Spastic Cerebral Palsy

Physical therapy is a set of exercises and physical interventions usually recommended for children with non-spastic cerebral palsy, regardless of how minor or severe the condition is.

It provides numerous benefits, including help with balance, coordination, muscle strength, physical endurance, and confidence. Physical therapy may involve hydrotherapy, exercise, massage, practice with movements, standing devices, and more.

Speech and language therapy helps children with non-spastic cerebral palsy who need assistance communicating effectively, a problem that can affect children with all forms of cerebral palsy. It enables the child to overcome language difficulties such as aphasia, dysphagia, stuttering, and more.[6]

Many children with non-spastic cerebral palsy benefit from medications that help control abnormal muscle movements and tremors. Sometimes, in mild cases of non-spastic cerebral palsy, medication may not be needed. Your child’s physician will tell you about medicines that may work best for particular symptoms.

In rare instances, especially when medication isn’t working, children with non-spastic cerebral palsy may need to undergo surgery, typically orthopedic surgery, to help correct limb problems and deformities.

Non-Spastic Cerebral Palsy Prognosis

The long-term outlook for children with non-spastic cerebral palsy depends upon how severe the disorder is, any associated medical conditions, and how well treatment options work.

Generally, children with non-spastic cerebral palsy can live long, productive lives with the right treatment plan and care.