Spastic cerebral palsy is the most common type of cerebral palsy.
However, even amongst people with spastic cerebral palsy, symptoms and management can vary quite a bit depending on the location and severity of brain damage.
This article will explain the main distinctions of spastic cerebral palsy and how to manage it.
What is the Most Common Type of Cerebral Palsy?
Spastic cerebral palsy makes up about 80% of all cerebral palsy cases.
It occurs when there’s damage to the motor cortex of the brain. This area of the brain is responsible for the planning and control of voluntary movements.
Spastic cerebral palsy can involve various areas of the body, but it always impacts movement.
Characteristics of Spastic Cerebral Palsy
Let’s go over some of the defining characteristics of spastic cerebral palsy:
1. High Muscle Tone
The ‘spastic’ part of spastic cerebral palsy refers to high muscle tone.
When your muscles are contracted, they become tight, which accounts for high muscle tone.
Children with spastic cerebral palsy will experience overactive, tight muscles.
This generally outwardly translates into jerky or exaggerated movements, as well as rigid positioning.
High muscle tone can be detrimental to a child’s growth and development.
2. Abnormal Gait Patterns
Many people with spastic cerebral palsy will also experience abnormal gait patterns.
They’re caused by severely contracted muscles that alter the way the legs move.
Examples of abnormal gait patterns in people with spastic cerebral palsy include:
- Toe-walking (walking on balls of the feet; heels never touching the ground)
- Scissor gait (knees together, locked hips, ankles turned inwards)
- Crouch gait (knees, hips, and ankles constantly bent; feet flat on the ground)
- Jump gait (knees and hips bent; standing on balls of feet without heels touching the ground)
- Spastic gait (foot-dragging walk typical in children with spastic hemiplegia)
Once a child learns to walk with an abnormal gait, walking that way quickly becomes habitual. Therefore, abnormal gait patterns are extremely difficult to correct (even after spasticity is treated).
Therefore, early intervention and treatment of high muscle tone in the legs are crucial.
Milder cases of spastic cerebral palsy will generally result in muscle weaknesses and reduced mobility.
It might take children a little bit longer to perform movements or movements might appear slightly unnatural.
For the most part, children with mild cerebral palsy are able to walk with the help of a crutch or walker to help with balance.
Types of Spastic Cerebral Palsy
There are four main types of spastic cerebral palsy.
They’re differentiated by the areas of the body they affect.
1. Diplegic Cerebral Palsy
Diplegic cerebral palsy is when your legs are affected more than your arms.
Affected patients will primarily have motor deficits in the legs. Examples include difficulty bending the knees, rotating the hips, or separating the legs.
People with diplegic cerebral palsy can also be affected in the arms and torso, just significantly less than in their lower extremities.
2. Hemiplegic Cerebral Palsy
Hemiplegic cerebral palsy is when only one side of the body (left or right) is affected.
Generally, the legs and arms will have more motor impairment than the torso.
3. Quadriplegic Cerebral Palsy
Quadriplegic cerebral palsy affects all of your body: arms, legs, and torso.
It can also include the mouth and tongue, which can make eating and speaking with cerebral palsy difficult.
This is the type of spastic cerebral palsy that results in the most widespread motor impairment and individuals will usually need the most caregiver assistance.
4. Monoplegic Cerebral Palsy
Monoplegic cerebral palsy is when only 1 limb has motor impairment.
Generally, it is an arm rather than a leg.
Why Everyone Experiences Cerebral Palsy Differently
Cerebral palsy is an umbrella term that describes many different types of motor impairments that result from damage to the brain.
The severity of cerebral palsy can range quite a bit; so even amongst individuals with the same type of CP, conditions can vary greatly.
Mild cerebral palsy means that the physical impairments don’t affect your body too much. You can still move, but your movements might be a little bit jerky or excessive.
Severe cerebral palsy means that your movements very difficult to control and you’ll need a lot more help with daily tasks.
While cerebral palsy refers specifically to motor impairments, it commonly co-occurs with other conditions that are a result of damage to other parts of the brain.
Managing Spastic Cerebral Palsy
While there is no cure for cerebral palsy, there are ways to help reduce spasticity so that it’s more manageable.
1. Physical and Occupational Therapy
Physical and occupational therapy can help lengthen tight muscles.
While physical therapy will be more exercise-oriented, occupational therapy will be more task-oriented.
Physical therapy generally focuses on increasing mobility through stretching and strengthening, while occupational therapy will typically address the ability to perform daily activities, such as getting dressed and feeding oneself.
They both are very low-risk forms of spasticity management and can help improve flexibility, strength, and range of motion.
While all children with CP can benefit from physical and occupational therapy, it will be most effective as a stand-alone treatment for children with mild CP.
More severe forms of CP will likely need alternative methods of treatment in addition to physical and occupational therapy.
Baclofen is a muscle relaxant that helps reduce spasticity by regulating the release of excitatory neurotransmitters.
You can take baclofen orally, by injection, or through a pump.
Children with mild spastic cerebral palsy should be able to take baclofen orally to limit spasticity, while more severe cases will benefit from more concentrated doses by method of injection or intrathecal pump.
Another common medication used to treat spasticity is Botox.
It only comes as an injection, but its effects can last for several months.
Keep in mind that medications only provide temporary relief and will not permanently relieve muscle stiffness.
However, when paired with therapy, the spasticity relief provided by medications can allow for greater mobility improvements to be made, some of which can carry over even once the medication has worn off.
Orthotics like braces can help improve form.
Spasticity can cause your limbs to bend or move in ways that aren’t ideal. This can be painful and cause uneven growth.
A brace will help hold limbs in place and promote proper alignment as children grow.
The most common surgery for spasticity is Selective Dorsal Rhizotomy.
Because of its invasive nature, it’s generally only performed in cases of severe spasticity.
It involves cutting nerve roots at the spinal cord to relieve severely spastic muscles.
Another prevalent surgery for reducing spasticity in individuals with cerebral palsy is baclofen pump implantation.
The pump is placed on the spinal column so that it can directly administer baclofen into the intrathecal space of your spinal cord.
The Most Common Type of Cerebral Palsy: Summary
That’s a wrap! Spastic cerebral palsy is the most common type of cerebral palsy by far.
Even though it makes up nearly 80% of all CP cases, spastic cerebral palsy presents itself differently in each individual.
Motor impairments will vary in location and severity, but all cases of spastic cerebral palsy involve high muscle tone.
Hopefully, this article helped you better understand what the most common type of cerebral palsy is and the various ways to manage it. Good luck!