Types Of Cerebral Palsy

The most common type of CP is spastic CP. In other words, 80% of the CP patients are Spastic. The cause of this type of CP is damage to the motor cortex (a region of the brain that controls voluntary movement) or pyramidal tracts (a group of neurons that carry signals from the motor cortex to the spinal cord and brainstem), affecting voluntary movement.

Spastic CP impacts the muscles and makes them stiff, resulting in difficulty in walking. This is due to weakness in muscles.

The symptoms are found in the entire body or just one side of the body.

Causes of Spastic Cerebral Palsy

Spastic cerebral palsy can be caused by damage to the motor cortex and pyramidal tracts. Both of them are important for movement control. Here are the causes in detail:

• Motor cortex damage hampers the voluntary movement of a person. This makes it harder to control and causes stiffness (spasticity).
• Pyramidal tract damage disrupts communication between the brain and spinal cord which affects movement signals.

Symptoms of Spastic Cerebral Palsy

Here are the symptoms of this CP:

• Stiff muscles in one or more body parts
• Difficulty with fine motor skills
• Abnormal posture or gait patterns
• Awkward reflexes
• Difficulty with crawling or walking
• Muscle weakness in affected areas
• Permanently tightened muscles or joints (contractures)
• Exaggerated, jerky movements (spasticity)

People with this form of cerebral palsy usually have problems with balance, coordination, and motor functions. They can’t keep the objects in their hands and hence can’t write. Around 5% of cerebral palsy patients have ataxic CP.

Ataxic cerebral palsy happens when the cerebellum (it controls balance and coordination) is damaged. The cerebellum helps fine-tune movements, and when it’s injured, signals may be delayed or missed. This causes physical challenges.

Causes of Ataxic Cerebral Palsy

Ataxic cerebral palsy is caused by damage to the cerebellum which happens before, during, or soon after birth.

The cerebellum performs tasks like motor control, balance, coordination, posture, and muscle movement. It also translates signals from the motor cortex to the central nervous system for proper movement of the body.

Damage to the cerebellum can happen due to:

• Oxygen loss due to placental failure or breech birth.
• Infections during pregnancy.
• Brain bleeding caused by a fetal stroke.
• Head trauma during or after birth.

Symptoms of Ataxic Cerebral Palsy

These are some of the symptoms of ataxic CP:

• Shakiness and tremors.
• Poor coordination.
• Speech difficulties.
• Problems with depth perception.
• Spreading feet apart when walking.

Dyskinetic CP patients can’t control their body movements and have involuntary, abnormal movements in the arms, legs, and hands. In some cases, movements are jerky and in others the movements are slow. Around 15% of cerebral palsy patients have dyskinetic CP diagnosed with dyskinetic cerebral palsy

Patients cannot control the tongue and it comes out of the mouth involuntarily, resulting in difficulty swallowing and talking in a few cases.

Causes of Dyskinetic Cerebral Palsy

Dyskinetic cerebral palsy is a movement disorder caused by brain injury. The kind of effect this damage causes depends on which part of the brain is damaged.

• It can be caused by basal ganglia damage. The basal ganglia are located within the cerebral cortex. It coordinates voluntary movement and regulates motor function, thinking, and learning. Damage to it interrupts motor function development and leads to involuntary movements.
• Dyskinetic CP can be caused by cerebellum damage. The cerebellum controls coordination, precision, fine motor skills, and balance. Damage here can make these tasks difficult and may also impact cognitive functions like communication and attention. Additionally, cerebellum damage is linked to conditions like autism or epilepsy.

These brain damages to the cerebellum or basal ganglia can result from:

• Infections, such as meningitis.
• Trauma to the developing brain.
• Lack of oxygen during brain development.

Symptoms of Dyskinetic Cerebral Palsy

These are some symptoms of this CP:

• Floppiness in the limbs.
• Feeding difficulties.
• Stiff or rigid body.
• Posture problems.

In mixed cerebral palsy, a child shows symptoms of two or more types of cerebral palsy, such as spastic, dyskinetic, or ataxic CP. It can be caused by brain damage during fetal development, birth, or early childhood. Because of the damage their movement, balance, coordination, and posture are affected.

Symptoms of Mixed Cerebral Palsy

Here are some symptoms of mixed cerebral palsy:

• Difficulty walking or holding objects.
• Stiff or floppy muscles.
• Uncontrolled or jerky movements.
• Speech problems.
• Abnormalities in posture.
• Delayed growth and development.
• Shakiness.

There can be other symptoms like drooling, learning disabilities, seizures, and vision or hearing problems.

In monoplegic cerebral palsy movement in a single limb is affected. It can be an arm, leg, hand, or foot. The extent of disability depends on the size and location of the brain injury causing the condition.

People with monoplegic CP may experience different effects on their affected limb. It can be weakness, stiffness, shaking, or loss of sensation. It happens in various combinations. The issue lies in how the brain sends signals to the muscles, not to the muscles themselves, as the brain’s messages are disrupted.

Diplegia mostly affects two limbs of a person. Usually, the legs are affected in most cases. However, children may also experience mild movement challenges in their upper body. This type of CP is usually caused by premature birth.

Many people with this cerebral palsy can walk but they may have difficulty in doing so. They may need assistance with mobility devices.

Hemiplegic cerebral palsy affects one side of the person’s body which includes one arm and one leg. Some people with this CP can walk, while others may need a wheelchair or assistive devices. It is the most common form of CP that affects 33-39% of people with this condition. 

When all four limbs are affected, it is called double hemiplegia. One side gets more affected than the other in this case.

Quadriplegia affects all four limbs of the CP patients. In this condition, the legs get more impacted than the arms. It can also affect trunk muscle tone and limit control of facial muscles. With uncontrollable facial muscles, it is difficult for the patient to eat and swallow.

Quadriplegia happens when a large portion of the brain gets damaged before or during the birth of a child.

In triplegia, three limbs of the patient are affected. It usually affects both legs and one arm. There will be stiffness and motor impairment in these limbs.

• https://www.ninds.nih.gov/health-information/disorders/cerebral-palsy
• https://www.sciencedirect.com/science/article/abs/pii/S1090379821001987
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9356840/
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9356840/
• https://www.ninds.nih.gov/health-information/disorders/cerebral-palsy
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9356840/