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Spastic Cerebral Palsy
Spastic cerebral palsy (CP) is the most commonly occurring form of cerebral palsy affecting between70 and 80 percent of all cases. This type of CP occurs when damage affects the cerebral cortex, which is the outer layer of the brain. Spastic CP can cause symptoms to affect just one area of the body, or the entire body.
Spastic cerebral palsy affects the muscles of the body and is noticeable by stiffness, tension or increased tone. Muscles normally work in pairs, when one group relaxes, another contract. This allows free movement in a particular direction. When damage to the brain has disrupted the natural brain-to-nerve communication path, this normal muscle movement is affected. Individuals with spastic CP experience over-active muscles that block normal movements. The muscles are always in a tense, or spastic, state.
Patients diagnosed with spastic cerebral palsy may have very mild symptoms that only affect a few types of movement, or they may have very severe symptoms that affect the whole body. While the condition of CP does not progress with time, muscle spasticity can increase. This is due to muscles becoming extremely stiff to the point where range of movement is limited a great deal, affecting joint health. Spastic CP may also worsen if the patient is over-exerted or anxious, causing fatigue. Spastic CP can also influence normal growth in children, as it affects the muscles and joints of the extremities. The condition can disrupt protein synthesis in muscle cells needed for growth, as well as longitudinal muscle growth. With time, children may develop deformities of the extremities, known as contracture.
The most commonly recognized symptoms of spastic cerebral palsy are jerky movements, muscle rigidity and difficulty with basic motor functions. Spastic cerebral palsy can fall into one of three categories:
Spastic Diplegia: This category is often recognized by “scissoring” of the legs; that is the legs cross at the knees making it very difficult to walk. The hip and leg muscles are extremely tight and rigid.
Spastic Hemiplegia: This refers to spastic CP that affects only one side of the body. For example, the arms and hands may be stiff, while the legs are not. One limb on the affected side may not develop properly as well.
Spastic Quadriplegia: The most severe form of spastic CP, spastic quadriplegia affects the arms, legs, and most of the body. It is usually very difficult to walk and talk, and seizures may occur.
While there is no cure for spastic cerebral palsy, there are treatments that can help relieve the symptoms. These treatments vary a great deal depending on the severity of the case. Muscle relaxers can sometimes be used to help relieve some of the muscle stiffness, as well as Botox administered directly into the muscles in an effort to help weaken them to reduce spasticity. Botox injections can provide relief for up to four months, with little to no known side effects. Orthopedic surgical treatments can also be performed to treat spastic CP. These types of surgery typically entail releasing muscles though tendon lengthening to improve the overall range of motion. While surgery cannot reduce spasticity, it can assist side effects of the condition. Treatment for spastic CP really needs to be catered to the individual, the severity of the condition and other medical conditions present. Choosing a course of treatment for children can be somewhat difficult for parents without proper medical guidance. It is always recommended parents consult a cerebral palsy treatment team, which includes a pediatrician, neurologist, neurosurgeon, physical therapist, physiatrist and orthopedic surgeon to coordinate the treatment planning process.
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The author of the substantive medical writing on this website is Dr. Christine Traxler MD whose biography can be read here