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Cerebral Palsy is one of the most common congenital problems. Of every 2,000 infants born,
five are born with cerebral palsy. Due to advances in obstetrical and pediatric care, what has
changed in the last 30 years is the type of cerebral palsy. Thirty years ago, most children with
cerebral palsy had athetoid cerebral palsy. Athetoid CP is caused by hyperbilirubinemia and
characterized by slow, writhing involuntary movements (no muscle control). Today only five or
ten percent of children have this type of CP due to advances in the treatment of
hyperbilirubinemia. Spastic cerebral palsy (muscle stiffness and restricted movement) has
become more prevalent because of advances in intensive care of premature babies, and
newborns have resulted in higher survival rates for children who would have otherwise died at
a very young age. Kids with Cerebral Palsy range widely in their degree of involvement from
very mild to very severe. The level of seating and positioning, from basic planar seating to fully
customized seating and positioning, needed to address the child's medical needs will depend
on the child. Treating and providing equipment for a child with diplegia will be very
different compared to treating and providing equipment for a child with spastic quadriplegia.
The different types of cerebral palsy may be classified by the type of movement problem
(spastic, athetoid, or hypotonic) or by the body parts affected (legs only, one arm and one leg,
or all extremities). Motor ability varies greatly from one child to the other; not all statements
hold true for all children with cerebral palsy.
Spasticity refers to the inability of a muscle to relax (increased muscle tone). You will find that
the child also has restricted range of motion due to the constant muscle rigidity. When the arm
or leg is moved, the initial resistance is strong. Sometimes the spasticity will relax, and other
times it will not relax. These changes in muscle tone interfere with normal development.
Athetosis refers to the inability to control the movement of a muscle. It characterized
sometimes by slow, writhing, involuntary movements. It can also be characterized by abrupt,
involuntary movement other times. Muscle tone changes from time to time, and because of
these tone changes, muscle contractures are less likely to occur in this form of Cerebral Palsy
than with spastic Cerebral Palsy. In athetoid Cerebral Palsy, it is difficult to regulate movement
and maintain posture. Hypotonia is characterized by flaccidity (no muscle strength). Ataxia
refers to balance and coordination problems.
Hemiplegia is cerebral palsy that involves one arm and one leg on the same side of the body
Diplegla (also called paraplegia) primarily involves both legs. Tetraplegia (also know as
quadriplegia) refers to a pattern involving all four extremities and may include the neck
muscles.
The term for the dominant type of muscle movement is often combined with the term describ-
ing the part of the body affected. The result is a more specific description of the
condition. For example, a child with spastic quadriplegiam has mostly spastic muscle problems
affecting most of his body. He or she may also have some form of athetosis or ataxia present.