Spastic Cerebral Palsy
Spastic cerebral palsy is the predominate form of cerebral palsy. Spastic CP is by far the most common type accounting for at least 3 out of every 4 cases of cerebral palsy. The single dominant feature characterizing spastic cerebral palsy is hypertonia -- severe involuntary rigidity and stiffness in the muscles in the affected area of the body. This involuntary muscle stiffness can significantly impair normal movements.
More so than other types of cerebral palsy, spastic CP tends to be localized in a specific region of the body. As a result, spastic CP cases are further classified into 3 separate sub-types based on the specific area of the body that is impacted: [i] diplegia (lower body); [ii] hemiplegia (left or right side); and [iii] quadriplegia (entire body).
More so than other types of cerebral palsy, spastic CP tends to be localized in a specific region of the body. As a result, spastic CP cases are further classified into 3 separate sub-types based on the specific area of the body that is impacted: [i] diplegia (lower body); [ii] hemiplegia (left or right side); and [iii] quadriplegia (entire body).
Symptoms and Characteristics of Spastic CP
The defining characteristic or symptom of spastic cerebral palsy is debilitating stiffness of the muscles (hypertonia). Instead of moving fluidly, muscles impaired by spastic CP tighten up and get rigid when movements are attempted. So if a child suffering from spastic CP in the lower body tries to move their legs to walk, the muscles in the legs involuntarily contract and get stiff making normal motion impossible. It may look there is something physically wrong with the legs, but the muscles are actually perfectly normal. The disabling hypertonia is triggered by the CP glitch in the brain.
The brain is designed to function as the command and control center for all body movements. Any voluntary movements of the body, from walking to lifting a finger, is orchestrated by the brain. The directives from the brain are transmitted to the various muscles by electrical impulse signals across nerve pathways. Proper execution of any type of body movement requires coordination and cooperation between opposing muscles. For example, to move the lower leg up one group of muscles needs to engage and contract while the opposing muscles need to disengage and relax at the same time. The impulse signals from the brain are supposed to instruct the muscles to engage and relax. In a person with spastic CP, however, the movement signals from the brain to the muscles are scrambled. Instead of instructing one muscle set to relax while opposing muscles engage, the brain signals both muscle groups to engage and contract simultaneously. Instead a fluid, normal movement the muscles basically oppose each other then become rigid and lock up.
The brain is designed to function as the command and control center for all body movements. Any voluntary movements of the body, from walking to lifting a finger, is orchestrated by the brain. The directives from the brain are transmitted to the various muscles by electrical impulse signals across nerve pathways. Proper execution of any type of body movement requires coordination and cooperation between opposing muscles. For example, to move the lower leg up one group of muscles needs to engage and contract while the opposing muscles need to disengage and relax at the same time. The impulse signals from the brain are supposed to instruct the muscles to engage and relax. In a person with spastic CP, however, the movement signals from the brain to the muscles are scrambled. Instead of instructing one muscle set to relax while opposing muscles engage, the brain signals both muscle groups to engage and contract simultaneously. Instead a fluid, normal movement the muscles basically oppose each other then become rigid and lock up.
Spastic CP Subtypes
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DIPLEGIA: With this subtype only the legs and lower body muscles are impaired with the arms and upper body generally unaffected. |
HEMIPLEGIA: This sub type is unilateral meaning it impairs one side of the body (left or right) and not the other. Both upper and lower muscles are involved. |
QUADRIPLEGIA: With this sub type the entire body (upper and lower / left and right) suffers from impaired muscle movement. This is the most severe subtype. |
Causes of Spastic CP
Like all types of cerebral palsy, spastic CP is caused by a defect in the brain resulting from damage during the earliest stages of the brain's formation and development -- fetal gestation, childbirth, or early infancy. Spastic cerebral palsy arises when cell damage to the brain occurs in the motor cortex and pyramidal tract in the brain. The motor cortex is in the region of the brain called the cerebral cortex. The motor cortex is tasked with originating and transmitting movement signals which coordinate voluntary movements of the body. The pyramidal tracts are basically the connections between the cerebral cortex and the nerve pathways in the spine. These nerve pathways connect to the muscles so when the pyramidal tract is damage it prevents normal signals from being transmitted for voluntary movements.
Damage to the motor cortext and pyramidal tracts during brain developments can be caused by a number of adverse events or complications during pregnancy or childbirth. The most common mechanism of damage to the brain during this period is oxygen deprivation. Until a baby is born and starts breathing on its own it remains dependent on the maternal oxygen delivery system. This delicate system is vulnerable to disruption, particularly during labor and delivery. Any temporary reduction or restriction of oxygen to the baby can cause hypoxic damage to cells in the brain and result in spastic CP.
Damage to the motor cortext and pyramidal tracts during brain developments can be caused by a number of adverse events or complications during pregnancy or childbirth. The most common mechanism of damage to the brain during this period is oxygen deprivation. Until a baby is born and starts breathing on its own it remains dependent on the maternal oxygen delivery system. This delicate system is vulnerable to disruption, particularly during labor and delivery. Any temporary reduction or restriction of oxygen to the baby can cause hypoxic damage to cells in the brain and result in spastic CP.
Treatment for Spastic CP
Spastic CP is the most treatable form of cerebral palsy. Like other forms of CP, physical therapy and occupational therapy are the mainstays of any treatment program for spastic CP. However, unlike other types of CP the primary symptoms of spastic CP can also be effectively treated with medication and also surgery. Prescription medications can help alleviate excessive muscle tightness.