Cerebral palsy (CP) is not a single condition, but rather a group of conditions that affect a person’s movement and posture. Caused by damage to the developing brain, there are 4 primary types of CP. Cerebral palsy is classified into types based on the body parts affected, the type of movement affected, and the severity of the symptoms.
The 4 primary types of CP are spastic cerebral palsy, dyskinetic cerebral palsy, ataxic cerebral palsy, and mixed-type cerebral palsy. Understanding the type of cerebral palsy is important when it comes to treating and managing symptoms. With the right care, your child can live the fullest possible life after a diagnosis of cerebral palsy.
The Birth Injury Lawyers Alliance (BILA) is a collective of skilled birth injury lawyers representing families and children throughout Canada. If your child has been diagnosed with cerebral palsy that you suspect was caused by a birth injury, we can help you determine if you have a potential medical negligence claim. Reach out today to schedule a free consultation with a birth injury lawyer in your province.
What Is Cerebral Palsy?
Cerebral palsy is a movement disorder that is caused by damage to the developing brain. This damage often occurs prior to birth. However, it can also be caused by a lack of oxygen to the brain during the labour and delivery process (birth asphyxia) or other birth trauma.
CP can affect a person’s posture and movement. Symptoms can range significantly based on the type of cerebral palsy and the severity of damage to the brain. They may include:
- Spasticity, or stiff muscles and exaggerated reflexes
- Ridgity, or stiff muscles with regular reflexes
- Ataxia, or lack of balance and muscle coordination
- Variations in muscle tone (being too stiff or too floppy)
- Tremors, or jerky movements that cannot be controlled
- Slow, writhing movements
- Difficulty walking
- Trouble with fine motor skills
- Favoring one side of the body
- Delays in speech development
- Drooling or difficulty with swallowing
- Trouble with chewing, sucking, and/or eating
- Difficulty with speaking
- Delays in motor skills milestones
- Delayed growth
- Intellectual disabilities
- Learning disabilities
- Seizures, which may be a form of epilepsy
- Hearing and/or vision loss
- Challenges with pain perception (either excessive or not feeling sensations like touch)
- Bowel and bladder issues
- Mental health conditions
In some cases, the symptoms of cerebral palsy are apparent right away. Alternatively, an infant may be diagnosed with another condition, such as hypoxic ischemic encephalopathy (HIE), that is linked with CP, leading doctors to more closely monitor a child’s growth and development. In other situations, a child may have milder symptoms, leading to a delayed diagnosis.
To diagnose CP, doctors will perform several tests. This may include an MRI and/or a cranial ultrasound to scan the brain and reveal areas of damage or abnormal development. Other common tests include an electroencephalogram (EEG) if your child is having seizures, and vision and hearing tests. Along with a medical history and description of symptoms, these tests can all be helpful in allowing physicians to determine the type of cerebral palsy a child has.
Types of Cerebral Palsy
There are 4 types of cerebral palsy: spastic, dyskinetic, ataxic, and mixed. These types are classified based on the body parts and type of movement affected, as well as the severity of the symptoms.
When cerebral palsy is classified by limb involvement, there are 4 key terms to understand:
- Quadriplegia means that all four (quad) limbs are affected. Plegia means impaired ability to move.
- Diplegia means that two (di) limbs are affected. This typically refers to a person’s legs being affected, although the arms may also be impacted to a lesser degree.
- Hemiplegia means that half (hemi) or one side of the body is affected. In many cases, the arm is more affected than the leg.
- Triplegia means that three (tri) limbs are affected. Typically, both legs and one arm are affected.
Next, doctors will examine how a child’s movement is affected (i.e., do they have stiff, tight muscles or decreased muscle tone?). Generally, they will determine the type of cerebral palsy based on the most prevalent movement disorder. It is possible for a child to have more than one type of movement disorder, even if they are diagnosed with a single type of CP.
Finally, doctors will use the Gross Motor Function Classification System (GMFCS) to determine a person’s capacity for independent mobility. Developed by CanChild, this system examines movements such as sitting, walking, and the use of mobility devices to categorize a child with CP into one of 5 levels. This number is important because it provides families and treating medical professionals with a good idea of the child’s current motor function and what their mobility needs may be in the future.
The levels are as follows:
- Level 1: A child can walk, climb stairs without using a railing, and perform gross motor skills, but their balance, speed, and coordination may be limited.
- Level 2: A child can walk in most settings and climb stairs with the assistance of a railing. They may have difficulty walking long distances, in crowded areas, or on uneven surfaces. They have limited ability to perform gross motor skills like running and jumping.
- Level 3: A child can walk using a hand-held mobility device in most indoor settings and may climb stairs with assistance and/or supervision. They use wheeled mobility for longer distances.
- Level 4: A child requires physical assistance and/or powered mobility in most settings.
- Level 5: A child is transported in a manual wheelchair in all settings and is limited in their ability to control leg and arm movement and maintain their posture.
With all of this diagnostic information, a doctor can determine the type of cerebral palsy that a child has. They can also start to put together a team to support a child’s needs. While there is no cure for cerebral palsy, treatment options such as medical, therapies, and surgical procedures can help a child to live their fullest possible life.
Spastic Cerebral Palsy
Spastic cerebral palsy is the most common type of CP. A person with spastic cerebral palsy, a person will have stiff muscles with exaggerated reflexes (known as spasticity). These movements often appear to be jerky and may be repeated.
Spastic CP is subdivided into three categories based on the body parts affected. This includes:
- Spastic Hemiplegia or Hemiparesis: This type of CP affects the limbs of one side of the body. Typically, an arm and a hand on the same side of the body are affected, although sometimes a leg is also affected. Children with spastic hemiplegia may have some delays in speech development, but typically do not have intellectual disabilities.
- Spastic Diplegia: This type of cerebral palsy causes spasticity in the legs. If the arms and face are affected, it is usually to a lesser degree. Children with spastic diplegia usually do not have intellectual disabilities or speech delays.
- Spastic Quadriplegia or Quadriparesis: The most severe type of cerebral palsy, spastic quadriplegia, causes severe stiffness of the limbs and a floppy, weak neck. Children with spastic quadriplegia often have intellectual disabilities, are unable to walk, and have challenges with speaking.
Dyskinetic Cerebral Palsy
Dyskinetic cerebral palsy may be diagnosed when a child has slow, uncontrollable, jerky movements in their limbs. Muscles in a child’s face may also be affected, causing them to drool excessively and/or make faces. Children with dyskinetic cerebral palsy have difficulty sitting up and walking, but typically do not have intellectual disabilities. Dyskinetic cerebral palsy includes several subtypes, including athetoid, choreoathetoid, and dystonic CP.
Ataxic Cerebral Palsy
Ataxic cerebral palsy is a type of CP that affects both balance and depth perception. As a result, people with ataxic CP often are unsteady on their feet. They may also have difficulty with some fine motor skills, like buttoning a shirt, writing, or reaching for an object.
Mixed-Type Cerebral Palsy
Brain damage may not affect just one area of the brain. As a result, a child may have wide-ranging symptoms, leading to a diagnosis of mixed-type cerebral palsy. This type of CP includes symptoms that are a mix of spastic, diskinetic, and ataxic cerebral palsy. The most common type of mixed CP is spastic-dyskinetic cerebral palsy.
No matter what type of cerebral palsy your child may have, getting a proper diagnosis is the first step towards helping them achieve their highest potential. If you suspect that their CP was caused by medical negligence, you may be able to pursue a claim against the responsible medical providers. While a lawsuit will not take away their cerebral palsy, it can help to provide the financial support necessary to ensure that your child thrives.
Reach Out to BILA to Talk to a Cerebral Palsy Lawyer in Your Province
A cerebral palsy diagnosis can be incredibly difficult for a family to accept. Regardless of the type of CP, it is still a lifelong condition that can cause many complications. When a child’s CP was caused by a preventable medical error, it can be even more difficult to come to terms with it.
If your child was diagnosed with CP as a result of a birth injury, you may be able to file a lawsuit against the at-fault healthcare professionals. While money won’t make your child whole again, it can help to ensure that they get all of the treatment and therapies that they need. At BILA, our cerebral palsy lawyers have decades of experience with birth injury and CP cases across Canada. Contact BILA today to speak with one of our lawyers.
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