Spastic cerebral palsy is the result of brain damage that causes muscle stiffness, making it difficult to move. This type of brain damage may occur before, during, or up to 2 years after birth. While some cases may be blamed on genetics, many cases of spastic cerebral palsy are believed to originate from the position of the fetus during pregnancy. It is hard to specify an exact medical cause for each case of spastic cerebral palsy. Approximately 80% of all cerebral palsy cases are spastic, making spastic cerebral palsy the most common form.
Risk Factors for Spastic Cerebral Palsy
Spastic cerebral palsy does not offer warning signs or an opportunity to avoid major medical issues. However, there are certain factors that increase the risk of spastic cerebral palsy. By noting medical problems, families can be proactive about minimizing their risk. If spastic cerebral palsy does occur, the family will be more prepared as they face new concerns.
Risk factors for spastic cerebral palsy include:
- Blood type incompatibility between fetus and mother
- Exposure to toxic chemicals during pregnancy
- Infections during pregnancy, such as rubella, herpes, cytomegalovirus, and toxoplasmosis
- Thyroid abnormalities, seizures, or forms of mental incompetency during pregnancy
- Complications during labor or delivery
- Infant is in “feet-first” position at beginning of labor
- Premature birth
- Low birth weight
- Low Apgar Score
- Severe, untreated jaundice
- Seizures during infancy
Types of Spastic Cerebral Palsy
Spastic Hemiplegia or Hemiparesis
Affects the arm, hand, or leg on one side of the body. The affected side of the body may be stunted in growth. Scoliosis may develop. Intelligence is typically normal, but speech issues are common.
Spastic Diplegia or Diparesis
Affects the legs more than the upper body. Leg braces or a walker may be necessary. It may be difficult to control the hands. Intelligence and language skills are generally normal.
Spastic Quadriplegia or Quadriparesis
These are the most severe forms of all cerebral palsies. Patients exhibit severe tension in limbs, with little or no tension in neck. An ability to walk is not likely. Mental retardation is common. Speaking is difficult. Seizures are frequent and not easily soothed.
Mixed types of spastic cerebral palsy are not uncommon. Patients may exhibit symptoms from any forms of spastic cerebral palsy, in addition to variations of non-spastic cerebral palsy.
Diagnosis and Relevant Conditions
Children with spastic cerebral palsy are typically diagnosed young, before 2 years of age. In milder cases, a doctor may not diagnose the patient until 4 or 5 years of age. The patient is more likely to gain some mobile independence if spastic cerebral palsy is diagnosed early. Certain types of spastic cerebral palsy may present as metabolic disorders. Obtaining adequate testing is important to rule out metabolic contributors.
Diagnosing spastic cerebral palsy is commonly done with neuroimaging procedures such as:
Cranial ultrasounds offer the least invasive diagnostic method, but they do not detect white matter changes within the brain. For this reason, cranial ultrasounds will not offer the most accurate diagnosis.
Computed Tomography Scans generate images that allow the doctor to map out damage within the patient’s brain. The structure of these damages provides for the most effective treatment.
Magnetic Resonance Imaging (MRI)
MRIs combine the use of radio waves, magnetic fields, and computers to create an image of the patient’s brain. This image is more detailed than a CT scan, making MRI scans the preferred testing procedure for spastic cerebral palsy.
Spastic cerebral palsy may cause other medical conditions, including:
- Impaired speech, vision, or hearing abilities
- Slow or abnormal development of body
- Spinal deformities, such as scoliosis
- Mental retardation
- Atypical sensations or perceptions
Treating Spastic Cerebral Palsy
Today’s treatments are not capable of curing spastic cerebral palsy. They are available to minimize patient discomfort, while maximizing the patient’s mobile independence. Depending on the severity of the spastic cerebral palsy and the medical treatment received, a patient may gain enough mobility to live independently during portions of adult life.
Treatment options for spastic cerebral palsy:
- Mechanical aids, such as braces or wheelchairs
- Communication aids, such as computers or voice synthesizers
- Speech therapy
- Physical and occupational therapy
- Counseling or behavioral therapy
- Drugs to subdue seizures, muscle spasms, or ease pain
Anne Keller, et al. “Walking Ability And Predictors Of Performance On The 6-Minute Walk Test In Adults With Spastic Cerebral Palsy.” Developmental Medicine And Child Neurology 52.6 (2010): e126-e132. MEDLINE with Full Text.Web. 8 July 2012.
Barrett, Rod S, and Glen A Lichtwark. “Gross Muscle Morphology And Structure In Spastic Cerebral Palsy: A Systematic Review.” Developmental Medicine And Child Neurology 52.9 (2010): 794-804. MEDLINE with Full Text.Web. 8 July 2012.
Fowler, Eileen G, Loretta A Staudt, and Marcia B Greenberg. “Lower-Extremity Selective Voluntary Motor Control In Patients With Spastic Cerebral Palsy: Increased Distal Motor Impairment.” Developmental Medicine And Child Neurology 52.3 (2010): 264-269. MEDLINE with Full Text.Web. 8 July 2012.
Saito, Naoto, et al. “Natural History of Scoliosis in Spastic Cerebral Palsy.” The Lancet 351.9117 (1998): 1687-92. ProQuest Nursing & Allied Health Source.Web. 8 July 2012.
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