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What Is Spastic Cerebral Palsy?

Muscle rigidity is a symptom of spastic cerebral palsy. Walking difficulties, difficulties handling items, and problems with vision, hearing, or speech are some of the symptoms and indicators.

A collection of mobility abnormalities brought on by brain injury sustained in infancy or early childhood are collectively referred to as "cerebral palsy." Permanent disabilities affecting muscle coordination and body mobility are common outcomes of cerebral palsy.

About 80% of children with cerebral palsy have spastic cerebral palsy, which is the most prevalent variety of the illness, according to the Centres for Disease Control and Prevention (CDC).

"Spastic" refers to tense muscles. "Cerebral" denotes having to do with the brain. "Palsy" refers to muscle weakness or trouble using your muscles.


What are the signs and symptoms of spastic cerebral palsy?

Individuals with spastic cerebral palsy experience abnormal or jerky movements as a result of tight muscles brought on by elevated muscular tone.

The bodily parts that are impacted determine the signs and symptoms that are present.

Muscle stiffness is primarily present in the legs in spastic diplegia. Signs or symptoms could be:
  • walking difficulties
  • abnormal posture or the incapacity to sit or stand up straight
  • knee stiffness that results in a shift in one's standing position
  • legs that are so tight that they move like scissor blades
  • hyperactive reflexes in the legs
Muscle rigidity on one side of the body, typically affecting the arms more than the legs, is known as spastic hemiplegia. Signs or symptoms could be:
  • Performing things with the hands or arms might be challenging, like:
  • getting dressed
  • writing
  • manipulating objects

  • a leg and arm on one side of the body that are slimmer and shorter
  • strolling on tiptoe or later in life than typical
  • scoliosis (curved spine)
  • delayed speech
The most severe kind of cerebral palsy, known as spastic quadriplegia, is characterised by muscle rigidity affecting the trunk, face, and all four limbs. Among the symptoms could be:
  • sluggish mouth movements or slurred speech
  • difficulty eating or drinking
  • extreme stiffness in the limbs
  • inability to walk
Seizures, hearing or vision problems, and moderate to severe intellectual disabilities are also associated with spastic quadriplegia.

Additionally, some medical experts refer to spastic cerebral palsy as "unilateral" or "bilateral." Bilateral refers to stiffness that affects the body's two sides. One side of the body is the only one affected by unilateral stiffness.


Vs. ataxic cerebral palsy

Five to ten percent of children with cerebral palsy have ataxic cerebral palsy, a less common form of the condition.

Children with ataxic cerebral palsy may struggle with their sense of depth, balance, and coordination. Among the symptoms and indicators are:
  • unusual actions or gestures, such as weak or wobbling movements
  • a broad gait and an unsteady gait
  • limited coordination
  • slow and imprecise movements
  • inability to control arm or hand movements, such as reaching for things
While there may be some similarities in the symptoms of spastic cerebral palsy, the movement issues are not related to difficulty with balance and coordination, but rather to stiffness in the muscles and joints.


What causes spastic cerebral palsy?

Brain injury or aberrant brain development in infancy or early childhood is the cause of cerebral palsy.

Among the potential reasons are:
  • haemorrhage in the brain of a newborn, typically brought on by foetal stroke
  • extreme oxygen deprivation in a baby's brain
  • head injury
  • changes to the genes that affect how the brain develops
The precise cause of cerebral palsy is frequently unknown.

Cerebral palsy can be more common in babies born due to several medical disorders and events that may occur during pregnancy and delivery. Among the circumstances and occurrences could be:
  • low birth weight
  • premature birth
  • simultaneous birth of several children, such as twins or triplets
  • fever and infections in the womb
  • exposure to toxic substances
  • parents who are female and suffer from long-term health issues, particularly autoimmune disorders


How is spastic cerebral palsy diagnosed?

Healthcare providers may begin by doing a physical examination on your child and getting information about their medical history to diagnose cerebral palsy.

They will search for any indications of a persistent, nonprogressive motor function (movement) issue. To evaluate your child's motor abilities, they could also prescribe tests.

During routine check-ups, medical staff may monitor and assess your child's:
  • development
  • growth
  • posture
  • coordination
  • muscle tone
  • motor skills
To rule out other illnesses or check for indicators of cerebral palsy, the medical team may also prescribe extra testing. These examinations may consist of:
  • cranial ultrasound scan
  • MRI scan or CT scan
  • blood tests
  • electroencephalogram
  • electromyogram
When a medical practitioner diagnoses cerebral palsy, they will further categorise the condition according to the type of movement disorder:
  • if there are any stiff muscles involved, spastic cerebral palsy
  • cerebral palsy that is dyskinetic if there are noticeable involuntary movements
  • if there is obvious abnormal coordination, ataxic cerebral palsy
  • mixed kinds, based on the indicators
The majority of children with cerebral palsy are diagnosed by the time they are 2 years old, while younger children who have minor symptoms can not be diagnosed until they are 4 or 5 years old.


How is spastic cerebral palsy managed?

The course of treatment for a child with cerebral palsy is determined by their symptoms. Objectives could be:
  • increased mobility
  • improved range of motion
  • reduced pain
  • decreased muscle spasms
Options for treatment may include:
  • drugs, including analgesics and muscle relaxants
  • physical therapy
  • speech and language therapy
  • dietary supplements
  • mental health counseling
  • occupational therapy
  • recreation therapy
  • surgery
  • assistive devices
  • control of associated illnesses, like:
  • pressure ulcers
  • osteoporosis
  • incontinence
A group of experts can assist in overseeing various forms of care and creating a treatment strategy specific to your child's symptoms.

Experts could consist of:
  • neurologists
  • developmental pediatricians
  • otologists
  • others
  • surgical specialists
  • ophthalmologists

Treatment for spasticity

The finest description of the targeted spasticity treatment required for children with spastic cerebral palsy may be found in this 2014 paper. The term "spasticity" describes the elevated muscular tone that causes stiff muscles.

The goals of treating spasticity include managing discomfort, preserving function, and preventing and correcting structural abnormalities of the bones and joints.

Children with spastic cerebral palsy are usually referred by primary care physicians to a surgical specialist, who can assist in choosing the best course of therapy.

Spasticity treatments could involve:
  • nerve blocks
  • soft tissue lengthening
  • onabotulinumtoxinA (Botox)
  • tendon transfers
  • joint stabilization
  • systemic antispasticity drugs, such as diazepam (Diastat AcuDial, Diazepam) and baclofen (Gablofen, Lioresal)
  • selective dorsal rhizotomy


What is the outlook for children with cerebral palsy?

The prognosis for kids with cerebral palsy is contingent upon the severity of the disorder and any comorbidities.

Children with cerebral palsy are enjoying longer, more independent lives as a result of advancements in diagnosis and treatment.

The life expectancy of most children with cerebral palsy is almost typical. According to a 2016 article, almost all children with the disease live long into adulthood.

Children with cerebral palsy, regardless of type, can lead active, satisfying lives if they receive the necessary care and assistance.



Takeaway

Muscle rigidity and abnormal movements are symptoms of spastic cerebral palsy, a movement disease.

Different degrees of handicap that impact the lower body, upper body, one side of the body, or the entire body can be experienced by children with the condition.

Children can live more active, joyful lives, increase their mobility, and experience less pain with treatment and continued assistance.

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