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Diplegic cerebral palsy, also known as spastic diplegia, is one of three different types of spastic cerebral palsy.  The most common problem with the disorder is 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 mostly the legs and sometimes the arms, making them stiff and contracted.  This makes crawling and walking difficult and most often, children will walk on their toes or with a wide “scissor-like gait.” 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. The upper extremities of the body may not be affected at all and may function normally. 
Some children with spastic diplegia will also associated symptoms, such as problems with coordination and balance, seizures, joint contractures, or cognitive impairment, which can range in severity.
Other symptoms of diplegic cerebral palsy include:
- Toe walking
- Flexed knees
- Late motor milestones (children with spastic diplegia may not begin walking until between the ages of 2-4)
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Spastic Diplegia Causes
As with other types of cerebral palsy, spastic diplegia is 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. 
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 carry out an emergency C-section when indicated
- Failure to detect, diagnose and treat maternal infections or medical conditions 
Other reasons infants may develop spastic diplegia include:
- Rh incompatibility
- Maternal seizures
- Maternal exposure to toxic substances
- Intrauterine stroke
- Severe or untreated jaundice
- Neonatal infection, such as meningitis
Spastic Diplegia Treatment
Most children with cerebral palsy are recommended to partake in physical therapy, and 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. 
Healthcare providers may prescribe medications that are aimed at decreasing spasticity. These include muscle relaxants, anticonvulsants, and other types of drugs that work on the muscles to decrease spasms. 
The child may need a walker, braces and other forms of mobility assistance. In some cases, surgery is indicated when there are increased pain or limb deformities.
Many parents are taking their children to massage and yoga therapy, which helps relax muscles via deep massage and builds strength. Talk to your child’s doctor if you think massage therapy or yoga might be a good choice for your child.
Spastic Diplegia Prognosis
There is currently no cure for spastic diplegia or any other type of cerebral palsy. The disorder itself will not 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.
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Retrieved from: https://www.stlouischildrens.org/our-services/center-cerebral-palsy-spasticity/about-selective-dorsal-rhizotomy-sdr
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Retrieved from: https://rarediseases.info.nih.gov/diseases/9637/spastic-diplegia-cerebral-palsy
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Retrieved from: https://www.medscape.com/answers/1179555-119930/what-causes-spastic-diplegic-cerebral-palsy
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Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/16508534
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