Spastic Cerebral Palsy

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Spastic cerebral palsy is the most common form of cerebral palsy, accounting for 70% to 80% of all people diagnosed. Spastic cerebral palsy causes increased muscle tone, stiff muscles, and difficulty walking.[1] Treatments include physical therapy, medications, and surgery.

What Is Spastic Cerebral Palsy?

Spastic cerebral palsy occurs as a result of brain damage, usually before or during birth or sometimes within the first years of a child’s life. It’s a disorder that affects coordination and control of motor function.

This results in developmental delays in children. The delays are red flags that usually lead to evaluation and a diagnosis.[2]

There are four primary types of cerebral palsy: spastic, dyskinetic, ataxic, and mixed.

Muscles need enough tone to maintain correct posture, enable standing and walking, and maintain speed and flexibility. Motor nerve fibers, via the spinal cord, interact with the muscles to help control how they move.

For someone with spastic cerebral palsy, brain damage affects muscle control, coordination, and movement, mainly in the arms and legs. This influences the way the spinal cord and nerves react, which then causes the muscles to become tense and spastic.

Like other types of cerebral palsy, spastic cerebral palsy does not get worse with age. It is not a progressive disease.

What Causes Spastic Cerebral Palsy?

All types of cerebral palsy result from brain injury, damage, or malformation. Damage to the motor cortex in the brain causes spastic cerebral palsy.

Most children develop cerebral palsy due to fetal development or brain damage that occurs during labor and delivery. Some examples of underlying causes include an infection in the mother during pregnancy, forceful use of birthing instruments, and untreated newborn jaundice.

Is My Child at Risk for Spastic Cerebral Palsy?

While it isn’t possible to predict if a child will develop cerebral palsy, certain factors increase the risk:

• Low birth weight
• Pre-term birth
• Complications during labor and delivery
• Infertility treatment
• Maternal infections
• Chemical exposure
• Mismatched Rh blood factor between baby and mother
• Jaundice in the baby
• Multiple gestations (twins or triplets)

Mothers cannot control for all the risk factors. You can reduce the risk your child will develop spastic cerebral palsy by staying healthy during pregnancy and keeping up with doctor’s appointments.

Subtypes of Spastic Cerebral Palsy

Spastic cerebral palsy may be classified as quadriplegic, diplegic, or hemiplegic, according to how and where it affects the body:

• Quadriplegia. Spastic quadriplegia affects both legs and arms. It may also involve the muscles of the torso and face.
• Hemiplegia. Spastic hemiplegia affects muscles on one side of the body, either right or left. In most cases, the arm is stiffer than the leg.
• Diplegia. Spastic diplegia occurs in the legs. In some cases, it causes mild stiffness or spasticity in the arms.

What Are the Symptoms of Spastic Cerebral Palsy?

Spastic cerebral palsy, also known as hypertonic cerebral palsy, is characterized by hypertonia, meaning increased muscle tone, leading to stiff and sometimes painful limbs.[3]

Symptoms may include:

• Involuntary limb movements
• Continuous muscle spasms and contractions
• Abnormal walking, marked by knees crossing in a scissor-like movement
• Joint contractures
• Limited stretching abilities
• Flexion at the elbows, wrists, and fingers
• Poor coordination and control of muscle movements

These symptoms can make it difficult for those with spastic cerebral palsy to walk, get dressed, brush their teeth, use the bathroom, and take a shower without assistance.

The limitations on activities of daily living (ADLs) will depend on how severe the disorder is. Children with mild cases of spastic CP may not need any help but may still have mild difficulties with ADLs.

If both legs are affected, children may also have problems transferring from one position to another, standing and sitting upright, walking, and running.

Children with spastic cerebral palsy may also develop associated conditions, including:[4]

• Speech difficulties
• Hearing problems
• Vision abnormalities
• Cognitive, learning, and behavioral disabilities
• Seizures

Other related issues may include:

• Drooling
• Difficulties with chewing and swallowing
• Hoarse voice or speech problems
• Breathing irregularities
• Failure to thrive or poor weight gain
• Gastric reflux
• Constipation and bladder incontinence
• Spinal and joint deformities

Can Children with Spastic Cerebral Palsy Walk?

Most children with cerebral palsy can walk. Many walk independently, but some need assistive devices like walkers and canes. 

Early interventions, including therapy and surgery, can improve mobility and help children walk more easily and independently as they get older.

How Is Spastic Cerebral Palsy Diagnosed?

There is no single test for spastic cerebral palsy. Doctors make a diagnosis based on observed symptoms and other conditions that might be caused by cerebral palsy, like seizure disorder.

Because a baby cannot tell you what’s wrong, observations are crucial for diagnosing this cerebral palsy. Doctors look at developmental milestones, growth, reflexes, and how a child moves. a

They can also use an assortment of tests to rule out other conditions and finalize a diagnosis of spastic cerebral palsy:

• MRI and CT scans of the brain
• Genetic tests
• Electromyography, which tests for muscle weakness
• Electroencephalography, which detects the brain’s electrical activity
• Tests for associated conditions, such as hearing or vision tests

Treatment Options for Spastic Cerebral Palsy

Although there’s no cure for any form of cerebral palsy, there are several treatment options available to help control the symptoms, including:[5]

• Physical therapy, as well as language, occupational, and behavioral therapies
• Medications to control symptoms, such as muscle spasms or seizures
• Baclofen pump (to help control muscle spasticity)
• Spine or spinal cord surgery (to repair scoliosis or reduce spasticity)
• Muscle-release and tendon-lengthening surgery
• Devices to aid in communication
• Orthotics, braces, or other devices to help with positioning, standing, or muscle control
• Constraint-induced therapy (CIT)

Keep in mind that treatment options will depend on the child’s age, how severe the symptoms are, and any associated disorders.

Parents work with a team of medical experts, including therapists, surgeons, dietitians, and neurologists, to implement the best treatments for the child.

What Is the Prognosis for Spastic Cerebral Palsy?

Again, there is no cure for spastic cerebral palsy, but with the proper treatment, children can grow up and thrive as adults.

It’s essential, however, to start a treatment plan as early as possible for the child to have the best outcomes–not only as an adult but as they grow through childhood and into adolescence.

Is Life Expectancy Shorter for a Child with Spastic Cerebral Palsy?

Life expectancy is not necessarily shorter for a child born with spastic cerebral palsy. It depends on many factors, especially the severity of the condition and associated disorders. Children with mild disabilities generally have an average life expectancy. 

Treatment also makes a big difference. Better care and treatment started earlier can significantly extend a child’s life expectancy.

What Is it Like to Live with Spastic Cerebral Palsy?

If your child has spastic cerebral palsy, it might seem hopeless that there is no cure. However, living with this condition doesn’t necessarily have to limit the quality of life.

Many children have milder symptoms and benefit significantly from therapies, treatments, and assistive devices. They might need accommodations at school and work, but most grow into normal, independent adults.

Keep in mind that every child is different. The best thing you can do is get your child’s cerebral palsy diagnosis as soon as possible and start treatments right away.

If you believe your child’s spastic cerebral palsy resulted from a doctor’s errors, contact a birth injury lawyer. They can determine if you have a case for medical malpractice and help you recover damages that will benefit your child’s future.