Types of Cerebral Palsy
The damage is found in the cerebral hemispheres. The child demonstrates muscle hypertonia, resulting in the whole body or a part of the body being rigid or stiff. Their movements are slow and their effectiveness depends on the degree of spasticity, which is different in each child. Often the position of the head causes unnatural positions throughout the whole body. For example, if the child turns his head towards the right, then his right hand will stretch and the left will bend, regardless of his desire to do otherwise. If he wants to bend his right hand, e.g. to bring towards his mouth to eat, then his head will turn towards the other side because the hand that is in flexion always “faces” towards the rear of the child’s head. There is usually an imbalance of activity, such that there is a stronger pull in one direction. This reflex action is also present in other forms.
The spasticity of the child becomes more intense when they move suddenly, when they are restless and generally excited due to happy or sad events or when found in certain positions. In fact, their tendency to stretch increases when left in a supine position (face up) on a flat surface while their tendency to bend increases when placed in a prone position (face down). The child with spasticity has a certain degree of imbalance which is why he doesn’t move from his position so as not to fall. With immobility he becomes more sluggish and stiff.
Lesions to the brain are most often the direct cause of the symptoms. Athetosis literally means uncoordinated movements. Children with athetosis move excessively. Athetoid movements are involuntary, convoluted, repetitive movements of the upper and lower limbs or only of the palms and toes or contractions of facial muscles. They become more intense when the child tries to do something or is in an excited state. The balance of these children is poor and so they easily fall. Often their speech is incomprehensible making it difficult for them to communicate. One rarely comes across children with pure athetosis. They usually present themselves as spasticity with evidence of athetosis, athetosis with evidence of spasticity or fluctuating muscle tone and athetosis with ataxic evidence.
Damage is located in the cerebellum. Children with ataxia show characteristic disturbances in balance. Their first years of life are hypotonic and they find it difficult to sit or stand. They often fall and they use their hands very awkwardly. Their steps are characterized by instability. When walking, they drag their body towards the front and take steps with open legs in order to maintain their balance. When an ataxic child stretches out his/her hand to grab an object, he either misses the target or fails to reach it. Pure ataxia is rare. It is usually combined with either spasticity or athetosis or both together.
The three above mentioned ways that Cerbral Palsy manifests itself in children don’t equally affect the various parts of their body. Depending on the parts of the body where it is displayed, the condition is described as hemiplegia, diplegia, quadriplegia, monoplegia, paraplegia and tripligia.
This condition is named so because the left or right side of the child’s body is affected. In fact, the whole body has difficulties because the non affected side is forced to function excessively. The leg is usually at an advantage compared to the hand. The muscle tone is in a constant spastic state, but some children can later develop athetoid movements of the limbs.
In this case, the whole body of the child is affected, but the legs more than the hands. Some times, the hands do not look as if they have difficulties. In this category, the children are almost totally spastic, although some of these children may appear to have mild athetoid movements of the limbs. Both children with hemiplegia as well as those with diplegia usually walk but some may need assistance.
The whole of the child’s body is affected, but hands and torso are either equally or more impaired. The distribution of the disability is usually very asymmetrical; in fact one side of the child’s body differs from the other. Children with tetraplegia may have any form of cerebral palsy, but more often a mixed form. In the last few years, the number of children who have severe forms of tetraplegia has decreased, possibly because there are better conditions during childbirth, resuscitation and neonatal care.
Monoplegia, Paraplegia and Tripligia
Only one part of the child’s body is affected, or only the legs or both legs and one hand however these incidences are rare. Usually these children have hemiplegia, diplegia, or tetraplegia respectively, even if the conditions are not visible. With the existence of all of these different types of conditions, it is obvious that each child with cerebral palsy is unique just as they are unique, irreplaceable human beings.