Diplegic cerebral palsy, also known as spastic diplegia, is one of nine different types of cerebral palsy. The most common problem with the disorder in muscle stiffness. It manifests during infancy and early childhood, with the average age of diagnosis being three years old.
Spastic Diplegia Symptoms
Spastic diplegia affects the legs and arms, making them stiff and contracted. The legs are generally affected more than the arms. In fact, the upper extremities of the body are usually able to retain good range of motion and muscle tone. Yet, both upper and lower limbs can equally be affected in some cases, depending on severe the spastic diplegia is. This makes crawling and walking difficult and most often, children will walk with a wide “scissor gate.” Legs can also turn inwards and cross at the knees due to excessive muscle contractions. Other children may not be able to walk at all.
A good majority of children with spastic diplegia will also have some form of cognitive impairment, which can range in severity. Other symptoms of diplegic cerebral palsy include:
- Toe walking
- Flexed knees
- Strabismus (One eye turning inwards)
- Seizures (not all children with spastic diplegia will develop seizures)
- Coordination and balance issues
- Late developmental milestones (children with spastic diplegia may not begin walking until between the ages of 2-4)
Spastic Diplegia Causes
As with other types of cerebral palsy, spastic diplegia is usually caused by brain damage, which generally happens before, during, or shortly after birth. According to the National Institute of Neurological Disorders and Stroke (NINDS), babies born prematurely and with low birth weight are at a heightened risk of developing cerebral palsy.
Periventricular leukomalacia, lesions that develop along the white matter of the brain, are a common occurrence in premature babies. These lesions interfere with the blood flow, which can result in oxygen loss, leading to brain damage and cerebral palsy.
Medical mistakes by healthcare providers account for around 10% of cerebral palsy cases and can happen due to:
- Improper use of forceps and other birth-assisting tools
- Failure to properly monitor fetal heartbeat and stress
- Failure to schedule and carry out an emergency C-section
- Failure to detect, diagnose and treat maternal infections
Other reasons infants may develop spastic diplegia include:
- Rh incompatibility
- Maternal seizures
- Maternal exposure to toxic substances
Spastic Diplegia Treatment
Most children with cerebral palsy are recommended to partake in physical therapy, but this is especially true for children with spastic diplegia. Physical therapy can help loosen stiff muscles, promote physical healing and wellness, help with balance and posture issues, build stamina and strength, and much more.
In addition to physical therapy, healthcare providers may prescribe medications to help the child manage pain and reduce seizures. In other cases, the child may need a walker, braces and other forms of mobility assistance. Orthopedic surgery may also be a treatment option.
Many parents are taking their children to massage and yoga therapy, which helps relax muscles via deep massages and build strength and inner peace. Talk to your child’s doctor if you think massage therapy or yoga therapy might be a good choice for your own child.
Selective dorsal rhizotomy (SDR) is recommended for some children. SDR is a newer type of surgery that entails gently cutting the abnormal rootlet nerve fibers in the spinal cord, which can help prevent deformities and improve vision, speech, and leg function. This form of surgery is usually reserved for younger children between the ages of two to four.
Spastic Diplegia Prognosis
There is currently no cure spastic diplegia or any other type of cerebral palsy. The disorder itself, however, will never worsen, although associated conditions may increase in severity over time. With early intervention and proper treatment, the prognosis for children with spastic diplegia is favorable.