Cerebral Palsy

Types

Cerebral palsy may be classified by the type of movement problem, the body part involved or by the balance and coordination problem that may be present.

• Spastic or Athetoid cerebral palsy. These two categories refer to the type of movement problems associated with cerebral palsy. Spasticity refers to the inability of a muscle to relax, while athetosis refers to an inability to control the movement of the muscle. In spastic individuals, when both legs are affected by spasticity, the legs may turn in and cross at the knees. This causes a characteristic walking rhythm, known as the scissors gait in which the legs move awkwardly and stiffly and nearly touch at the knees. Individuals with spastic hemiplegia may also experience hemiplegic tremors on one side of the body. If these tremors are severe, they can seriously impair movement. In athetoid individuals, uncontrolled, slow, writhing movements are most characteristic. These abnormal movements usually affect the hands, feet, arms, or legs and, in some cases, the muscles of the face and tongue, causing grimacing or drooling.
  
• Ataxia. This is a classification used to describe cerebral palsy that affects balance and coordination. Most often ataxic individuals experience poor coordination; walk unsteadily, placing their feet unusually far apart; and have trouble with quick or precise movements, such as writing or buttoning a shirt. Another possible quality of ataxia is an intention tremor, where initiating a voluntary movement, such as reaching for a glass, causes a trembling that affects the body part being used and that worsens as the individual approaches the object.
  
• Hemiplegia, Diplegia, Quadriplegia. Hemiplegia is cerebral palsy that affects one arm and one leg on the same side of the body. Diplegia is cerebral palsy that affects primarily both legs. Quadriplegia refers to cerebral palsy that affects all four extremities as well as the trunk and neck muscles.
  
• Mixed. The various symptoms of cerebral palsy are highly individual, and it is common to combine any of the above symptoms - to the extent that the often fourth classification is referred to as mixed. The most common mixed form is spasticity with athetoid movements, but other combinations are also possible.