• Spastic cerebral palsy

‘Spastic' means ‘stiff' and this form of cerebral palsy causes the muscles to stiffen and decreases the range of movement in the joints. Spastic cerebral palsy is caused by impairment in the cerebral cortex (the outer layer) of the brain and is the most common form of cerebral palsy. It can affect many different areas of the body. Generally someone with spastic cerebral palsy has to work hard to walk or move. If the person is only affected on one side of their body the term used to describe this is ‘hemiplegia'. If their legs are affected but their arms are unaffected or only slightly affected this is known as ‘diplegia'. If both arms and both legs are equally affected, then the term used is ‘quadriplegia'.

• Dyskinetic (also dystonic or athetoid) cerebral palsy

Dyskinetic means difficulty with movement. This type of cerebral palsy is caused by impairment in the basal ganglia area of the brain. People with dyskinetic cerebral palsy make involuntary movements, because their muscle tone changes rapidly from floppy and loose to tense and still, in a way they cannot control. Speech can be hard to understand as there may be difficulty controlling the tongue, breathing and vocal cords. Hearing problems are also common.

Dystonic cerebral palsy affects the movement of the body and presents as slow, rhythmic twisting movements of the trunk, or an arm or leg. It can also include abnormal postures.

• Ataxic cerebral palsy

People with ataxic cerebral palsy find it very difficult to balance. They may also have poor spatial awareness, which means it is difficult for them to judge their body position relative to other things around them. Ataxia affects the whole body. Most people with ataxic cerebral palsy can walk but they will probably be unsteady. They may also have shaky hand movements and irregular speech.

It can often be difficult to diagnose conclusively what type of cerebral palsy a person has, as they may have a combination of two or more types. It is important to bear in mind that no two people with cerebral palsy are affected in the same way. Some have such a mild form of cerebral palsy that its effects are barely noticeable. Others may be extremely affected and require help with many or all aspects of daily life.

 

Symptoms & associated difficulties

All types of CP are characterized by abnormal muscle tone (i.e. slouching over while sitting), reflexes, or motor development and co-ordination. There can be joint and bone deformities and contractures (permanently fixed, tight muscles and joints). The classical symptoms are spasticities, spasms, other involuntary movements (e.g. facial gestures), unsteady gait, problems with balance, and/or soft tissue findings consisting largely of decreased muscle mass. Scissor walking (where the knees come in and cross) and toe walking (which can contribute to a gait reminiscent of a puppet) are common among people with CP who are able to walk, but taken on the whole, CP symptoms are very diverse. The effects of cerebral palsy fall on a continuum of motor dysfunction which may range from slight clumsiness at the mild end of the spectrum to impairments so severe that they render co-ordinated movement virtually impossible at the other end the spectrum.

Children with cerebral palsy may also have difficulties with:

• constipation

• sleeping

• speech and language

• chewing & swallowing

• comprehension & understanding

• epilepsy and seizures- up to half of all children with CP experience one form of seizure or another.

• difficulty distinguishing or comparing shapes due to disturbances in visual or spatial perception

• learning difficulties

• behavioural disorders