There are four types of cerebral palsy (CP), a group of neurological disorders that impact movement, balance, and posture. The types are differentiated by the movement issues they cause and the body part(s) being affected.
Cerebral palsy is caused by brain damage or defective development of the brain, especially the cerebral cortex, which controls motor functions. Patients with CP have defects in sensations, perception, cognition, and communication and behavior, as well as other musculoskeletal problems. They also may experience seizures.
The types of cerebral palsy are spastic, dyskinetic ataxic, and mixed. The following is more information about each type, and in the case of spastic CP, each of its subtypes.
This is the most common type of cerebral palsy, affecting about 70% of all patients. Spastic CP, like all types of the disorder, is caused by damage to the cortex region of the brain. However, this type of CP, in most cases, is specifically caused by damage to the brain’s pyramidal tract, which relays signals from the brain to the muscles. For that reason, spastic CP also is sometimes called pyramidal CP.
The range and severity of spastic CP symptoms depend on the extent of the brain injury. Signs of the disease may not be obvious until children start missing developmental milestones. In most cases, it takes up to 18 months before physicians can diagnose a child with spastic CP.
Individuals with spastic CP have hypertonia, or too much muscle tone, leading to stiff and tight muscles that cannot relax in some body parts. The affected joints usually become rigid and difficult to move, and patients may struggle to control their movements, eat, and speak. They also usually walk with an abnormal gait, such as walking on their toes instead of using the whole foot.
People with this subtype are affected on only one side of the body — in the arm, hand, and leg of either the right or left side. Children with spastic hemiplegia may have delays in learning to talk, but their intelligence is usually unaffected.
This refers to individuals with muscle stiffness mostly in the legs, whereas the arms and face are less severely affected. The intelligence and language skills of patients with this type of CP also are usually unaffected by the cerebral palsy.
This is the most severe form of CP. It involves severe stiffness of the arms and legs, and a floppy or weak neck. Individuals with spastic quadriplegia may be unable to walk and may have trouble speaking. These patients also may have moderate-to-severe intellectual and developmental disabilities.
Dyskinetic CP, also known as extrapyramidal CP, accounts for 10-20% of all cerebral palsy cases. It is characterized by slow and uncontrollable jerky movements of the hands, feet, arms, or legs. The face muscles and tongue may be overactive and cause some children to drool or make faces. Individuals with this type of CP also may have trouble sitting straight or walking.
This type of CP is not usually linked with any intellectual problems.
Some patients with this CP type may experience rigidity and dystonia — involuntary muscle contractions that cause repetitive or twisting movements — that are more often seen in the upper limbs than in the lower ones. Some individuals with dyskinetic CP also have difficulties with eating and speech.
About 10% of CP patients have ataxic CP, which occurs when the cerebellum is affected. The cerebellum is the part of the brain that regulates voluntary muscle movements and is responsible for smooth and balanced muscular activity. Ataxic CP usually is diagnosed when the patient is about 18 months old.
Individuals with this CP type have problems with balance and perception of depth. They walk in an unsteady manner with their feet far apart from one another and usually have difficulties with quick or precise movements, including writing or buttoning a shirt.
Individuals with mixed CP have damage to many parts of the brain and show symptoms of two or more types of cerebral palsy. In most cases of mixed CP, patients have athetoid and spastic CP movements, but other combinations also are possible.
Last updated: Feb. 24, 2020
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