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Types
of cerebral palsy:
Cerebral palsy
is a broad term which encompasses many different disorders of movement
and posture. To describe particular types of movement disorders
covered by the term, pediatricians, neurologists, and therapists
use several classification systems and many labels. To understand
different types of cerebral palsy more clearly, you must first understand
what professionals mean by muscle tone.
Muscle
tone refers to the amount of tension or resistance to movement
in a muscle. Muscle tone is what enables us to keep our bodies in
certain position or posture. Changes in muscle tone is what enables
us to move. For example, to bend your arm to brush your teeth, you
must shorten (increase the tone of) the biceps muscles on the front
of your arm at the same time you are lengthening (reducing the tone
of) the triceps muscles on the back of your arm. To complete a movement
smoothly, the tone in all muscle groups involved must be balanced.
The brain must send messages to each muscle group to actively change
its resistance.
All children
with cerebral palsy have damage to the area of the brain that controls
muscle tone. As a result, they may have increased muscle tone, reduced
muscle tone, or a combination of the two (fluctuating tone). Which
parts of their bodies are affected by the abnormal muscle tone depends
upon where the brain damage occurs.
There are
three main types of cerebral palsy:
- spastic
(stiff and difficult movement)
- athetoid
(involuntary and uncontrolled movement)
- ataxic
(disturbed sense of balance and depth perception)
(There may
be a combination of these types for any one person)
Spastic:
Spastic cerebral palsy is the most common type of cerebral palsy.
It affects about 80 percent of all children with cerebral palsy.
Children with this type of cerebral palsy have one or more tight
muscle groups which limit movement. If muscle tone is too high or
too tight, the term spastic is used to describe the type of cerebral
palsy. Children with spastic cerebral palsy have stiff and jerky
movements because their muscles are too tight. They often have a
hard time moving from one position to another. They may also have
a hard time holding and letting go of objects. If your child has
spastic cerebral palsy, it is because he or she has damage to the
part of the brain that controls voluntary movements.
Ataxic:
Low muscle tone and poor coordination of movements is described
as ataxic cerebral palsy. Children with ataxic cerebral palsy look
very unsteady and shaky. This rare form of cerebral palsy affects
the sense of balance and depth perception. Affected persons often
have poor coordination and walk unsteadily with a wide based gait,
placing their feet unusually far apart. They have a lot of shakiness,
like a tremor you might have seen in a very old person, especially
when they are trying to handle or hold a small object such as a
pen. Because of the shaky movements and problems coordinating their
muscles, children with ataxic cerebral palsy may take longer than
other children to complete certain tasks such and writing a sentence.
This form affects about 5-10 percent of the children diagnosed with
cerebral palsy.
Athetoid:
About 10 percent of children with cerebral palsy have the athetoid
type. Athetoid cerebral palsy is caused by damage to the cerebellum
or basal ganglia. These areas of the brain normally process the
signals that enable smooth, coordinated movements as well as maintaining
body posture. Damage to these areas may cause a child to develop
involuntary, purposeless movements, especially in the face, arms,
and trunk. These movements often interfere with speaking, feeding,
reaching, grasping, and other skills requiring coordinated movements.
For example, involuntary grimacing and tongue thrusting may lead
to swallowing problems, drooling and slurred speech. The movements
often increase during periods of emotional stress and disappear
during sleep. In addition, children with athetoid cerebral palsy
often have low muscle tone and have problems maintaining posture
for sitting and walking.
Mixed cerebral
palsy:
About 10 percent of children with cerebral palsy have what is
known a mixed-type cerebral palsy. These children have both the
tight muscle tone of spastic cerebral palsy and the involuntary
movements of athetoid cerebral palsy. This is because they have
injuries to both the pyramidal and extrapyramidal areas of the brain.
Usually the spasticity is more obvious at first, with involuntary
movements increasing when the child is between nine months and three
years old. The most common mixed form includes spasticity and athetoid
movements, but other combinations are also possible.
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