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.

Cerebral palsy (CP) is a condition which is caused by a brain injury before birth or sometimes during delivery, which can happen if a baby is starved of oxygen during birth. The condition can cause varying degrees of disability from mild to severe – and movement is affected, so in severe cases a person may have very limited movement, or any movement may be affected by muscle spasms or limbs may be rigid.

Depending on the area of the brain which has sustained injury, speech, sight, hearing and cognitive skills may also be affected.

Types of cerebral palsy

Cerebral palsy can take the form of three different patterns which affect muscle function and movement:

·         Ataxic cerebral palsy affects balance and walking and perceptions of the space around a person. Patients may be unsteady on their feet or adopt an unusual posture with widely spaced feet and legs when they walk. Ataxic CP can also make reaching for objects difficult and the patient may also suffer from tremors.

·         Athetoid/dyskinetic (ADCP) affects up a one-fifth of cerebral palsy patients and causes limbs, hands, feet and face or mouth to writhe. Patients may also drool, experience unusual facial spasms or have problems with speech if the facial muscles have been affected by a brain injury

·         Spasticity is the most widely known form of cerebral palsy and affects around 80% of cerebral palsy patients. Spasticity causes contraction in muscles, involuntary movement of muscles and shaking or body tremors. Muscle contraction results in the knees being turned inwards when the patient walks. The three types of spastic cerebral palsy are quadriplegia (all four limbs affected), hemiplegia (both limbs affected on just one side of the body) and diplegia (either legs or arms are affected).

Brain injury can mean that the individual has problems communicating – they may know what they want to say but the damaged part of the brain cannot process the thought into actual speech.

But people with cerebral palsy are no less intelligent than their peers and also possess distinctive personalities, just like everyone else. Cerebral palsy does not mean that a child will not develop likes and dislikes, talents, skills and their own unique personality traits, or will be able to play a role within the family.

Children and cerebral palsy

The first signs of cerebral palsy usually appear within the first 12 months of a baby’s life – and parents may at first notice that their baby may not respond to sight or sound, may not be able to grasp toys, or may roll over onto one side instead of being able to develop an upright posture and move normally. How a baby is affected will depend on which area of the brain has suffered damage.

Children with cerebral palsy will benefit from early assessment and medical intervention – and many children adapt to their condition remarkably well and become active and engaged in life in ways which may exceed parents’ initial fears and expectations.

New technology can now predict the sort of aids a child with cerebral palsy may need as they grow, including mobility devices or modifications to the home or aids to help mobility at school or work.

Long term effects of cerebral palsy

In cerebral palsy patients, the brain damage sustained during pregnancy or birth does not get any worse, but other health issues may develop as a result of the disability – for example a high risk for osteoporosis (brittle bones) and/or fractures or hip dislocation if the legs are affected.

People with cerebral palsy also have a normal life expectancy although those with very severe disability may require 24/7 care.