ABOUT CEREBRAL PALSY
Spastic, Ataxic, and Dyskinetic Cerebral Palsy
Motor cortex (https://cerebralpalsy.org.au)
Spastic Cerebral Palsy
According to the Cerebral Palsy Alliance, “Spastic cerebral palsy is the most common type of cerebral palsy. The muscles of people with spastic cerebral palsy feel stiff and their movements may look stiff and jerky.” 70-80% of CP cases are spastic. Spastic CP may be either bilateral (limbs on both sides affected) or unilateral (limbs on one side of body are affected).
Spasticity is caused by damage to the motor cortex and is a form of hypertonia (increased muscle tone) which causes stiff muscles and difficulty performing movements with the affected areas of the body. Depending on which areas are affected (e.g., upper or lower limbs, face), a person with spastic CP may have a scissor-like gait due to hip and leg muscle problems (i.e., flexion and/or adduction), and may also have trouble with the movements required to manipulate objects, feed and take care of themselves, walk and run, sit and stand, and speak, among other things.
Ataxic Cerebral Palsy
According to the Cerebral Palsy Alliance, “Ataxia is the least common form of cerebral palsy. Ataxia means ‘without order’ or ‘incoordination.’ Ataxic movements are characterised by clumsiness, imprecision, or instability. Movements are not smooth and may appear disorganised or jerky.” Only 6% of CP cases are ataxic.
Ataxia is caused by damage to the cerebellum - the brain’s balance center - which results in difficulty moving and executing day-to-day activities. A person with ataxic CP may have an unstable wide-base gait which causes them to fall. Depending on the affected areas (e.g., upper limbs, lower limbs, face, eyes), a person with ataxia may have tremors that affect the motor skills required to use objects, take care of themselves, walk, speak, swallow, and adjust their eyes to see.
Dyskinetic Cerebral Palsy
According to the Cerebral Palsy Alliance, “People with dyskinetic forms of cerebral palsy have variable movement that is involuntary (outside of their control). These involuntary movements are especially noticeable when a person attempts to move.” Only 6% of CP cases are dyskinetic.
Dyskinetic movements are caused by damage to the basal ganglia: the part of the brain that coordinates messages between movement center and spinal cord, thereby regulating voluntary movements. The basal ganglia also plays a role in controlling emotion, mood, and behaviour. There are three categories of dyskinetic movements: dystonia, athetosis, and chorea, which may occur in conjunction with one another.
Dystonia "is characterised by involuntary muscle contractions that result in slow twisting or repetitive movements, or abnormal sustained postures, that are triggered by attempts to move." Its characteristics may include:
"Repetitive and sustained movements
Movements that are rapid or slow and are often painful
Involuntary movements triggered by attempts at controlled movement
Involuntary movements occur more frequently when the person is tired, anxious, tense, or emotional
Pain may also result in an increase in these movements."
Athetosis involves “slow, continuous, involuntary, writhing movements that are present at rest and made worse by attempts to move.” Muscle tone may vary between floppy (hypotonia) and varying motion (hyperkinesia), which may result in the affected person not being able to maintain a constant posture. Its characteristics may include:
Slow, involuntary muscle movements, restless and constant irregular movements in hands, feet, arms, or legs which may increase during emotional stress.
The involuntary and uncontrollable movement fluctuations sometimes affect the whole body and make it difficult to manipulate objects
Grimacing, drooling, and/or trouble breathing, eating, drinking, and speaking if face and tongue muscles are affected
Only able to be still if completely relaxed or asleep.
Chorea “is derived from the Greek word for ‘dance’. Chorea is characterised by involuntary movements that are brief, abrupt, irregular and unpredictable.” Those who experience chorea may have movements that are fidgety and clumsy or wild and violent (ballismus), depending on severity. Depending on the affected areas, they may have trouble with limb movements, speech, and/or swallowing, all of which may worsen with stress."
(Cerebral Palsy Alliance)
Basal ganglia (https://cerebralpalsy.org.au)