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Cerebral palsy is the term used to describe a wide range of neurological conditions. There are three main types of cerebral palsy – and within these, a further three main subsections which cover different spasticity conditions.

The main three types of cerebral palsy are:

Athetoid/dyskinetic (ADCP) affects around one-fifth of those with cerebral palsy. ADCP symptoms include abnormal writhing in the limbs, hands, feet and face or mouth. Those with ADCP may also drool or suffer facial contortions if the facial muscles are particularly affected. They may also have problems with speech and communication.

Ataxic affects around one-tenth of people with cerebral palsy and affects balance and walking. Ataxic cerebral palsy can also affect an individual’s perception of space, making it difficult for them to judge their position as they walk. This can cause an unbalanced gait, with feet and legs splayed during walking. There may also be more complex issues regarding movement and mobility with ataxic CP – and this can mean difficulties in carrying out specific motor functions such as holding an object (eg a pen) or reaching for an object. Intricate actions like tying a shoelace can also be problematic for people with ataxic cerebral palsy. They may also suffer from tremors and muscle spasms.

Spasticity is the most commonly diagnosed type of cerebral palsy, with around 80% of cerebral palsy patients having this form of the condition. Spasticity causes the muscles in limbs to contract and stiffen, which makes movement very difficult. Botox and other muscle relaxants such as Diazepam (Valium) can be used to help improve muscle function. The classic gait associated with cerebral palsy is a walking style with knees turned inwards and this is a result of spasticity in the leg muscles. The three different types of spasticity in cerebral palsy patients affect different limbs and these are:

·         All four limbs (guadriplegia)

·         Both limbs on one side of the body (hemiplegia)

·         Arms or Legs (diplegia).

Research into cerebral palsy and its recognition among the medical profession has been ongoing since 1860, when English orthopaedic surgeon William Little noticed that some babies with abnormal movements and physical disabilities had been born after a difficult delivery.

The term cerebral palsy was used from 1887 onwards to describe the range of neurological symptoms Little had associated with birth difficulties. It was coined by British medical doctor Sir William Osler. Psychoanalyst Sigmund Freud made the association between premature birth and spastic diplegia in 1897.

Diplegia as a condition is mainly associated with mobility problems in the legs, as with diplegia problems with mobility in the arms are usually less severe. Children with diplegia may have shorter muscles which grow more slowly and this is turn can cause problems with movement and walking. If the tendons become short in the ankles and feet, a child may walk on tiptoe, which happens if the Achilles tendon is shortened.

When children have diplegia, the shortened muscles can also have a knock on effect on other areas of the body, including the hips. Hip dislocations are possible with diplegia and children are usually monitored closely to prevent this happening.

There are also other forms of cerebral palsy including a condition when just one limb is affected (monoplegia), which is rare. In triplegia, three limbs are affected by cerebral palsy and most of the time triplegia involves spasticity of both legs and one arm.

In cases of monoplegia and triplegia, children may be medically treated in exactly the same way as if they had hemiplegia or quadriplegia. This is because monoplegia and triplegia may actually be a form of cerebral palsy in which one limb has very mild symptoms which may be almost unnoticeable, but is still affected.

If a person with cerebral palsy has a set of symptoms which span each category, then this usually referred to as mixed CP unless one set of symptoms is obviously predominant over the other types.



 


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