Spastic Diplegia Cerebral Palsy (also referred to as Diplegic Cerebral Palsy) is one of the most common types of CP diagnosed in children today.
With that said, you may be wondering…
- What does Spastic Diplegia mean?
- What are the signs and symptoms to look for?
- What types of treatment are available?
- How is it caused?
- Can it be cured?
Let’s dive in.
What is Spastic Diplegia Cerebral Palsy?
When you hear the term Spastic Diplegia it refers to the lower body part, the legs.
It’s a condition affecting the spasticity of the legs.
Those who have spastic diplegia experience lower extremity challenges.
So what symptoms do you need to look for?
Here are common spastic diplegia cerebral palsy symptoms and signs to look for:
- Muscle stiffness (also known as hypertonia)
- Muscle weakness (also known as atrophy)
- Poor balance and movements (may appear unsteady)
- Scissor walk
- Toe walking
Now let’s cover one of the most common symptoms, scissor walk.
Commonly, a child with spastic diplegia may move with a ‘scissor walk’ where their knees turn inward.
This is due to muscle stiffness that occurs in the hips and legs.
‘Scissor walk’ (also known as scissoring gait) is an abnormal walking pattern where the thighs and knees press together or cross over each other.
Here is a short clip to show you what a ‘scissor walk’ looks like (video by Trishla Foundation).
When a child is diagnosed with cerebral palsy it happens due to brain damage that occurs either before or right after birth.
The same goes for Spastic Diplegia Cerebral Palsy.
The cause or ‘how it happened’ all stem from damage to the brain that took place at a specific point in time.
So you may be wondering what causes a child to have brain damage?
Let’s get into that next.
According to the National Institute of Neurological Disorders and Stroke (NINDS), babies born prematurely and with low birth weight are at a heightened risk of developing cerebral palsy.
Sadly, a small percentage of cerebral palsy cases result from a medical mistake by a healthcare provider.
When this happens, medical tools are improperly used to deliver the baby causing damage to the brain (like forceps or vacuum extractors).
To summarize, here are the common risk factors that may cause Spastic Diplegia Cerebral Palsy:
- Babies born prematurely
- Babies born with low birth weight
- A medical mistake caused by a healthcare provider
- Multiple births (twins, triplets, etc.)
- When a baby is breech
- The mother was exposed to methyl mercury (which is very toxic and can happen from eating fish or shellfish)
- The mother and child’s blood types are not compatible
- Infections during pregnancy
- A medical condition of the mother (such as thyroid issues or seizures)
Again, these are risks to keep in mind but it does not mean this is the be-all-end-all.
Early Warning Signs To Look For
The majority of kids who become diagnosed with cerebral palsy are usually between the ages of 1 to 2 years old. It’s not a condition that’s commonly diagnosed right away.
Normally, signs of developmental delays become more apparent as the child gets older, reaching ages 1 to 2 years.
Developmental milestones are pivotal moments in a parent’s life when their child is learning to roll over, crawl, stand, or walk. When these pivotal moments are not being met, it may indicate motor delay issues.
With that being said, here are early warning signs to look for:
- Unable to hold up their head while being picked up, lying down on their back, or stomach
- When held, they feel ‘floppy’ or ‘stiff’
- When held, the legs become tense or cross like scissors
- Feeding or swallowing difficulties
- Unable to roll over or sit up on their own
- Has difficulty bringing their hands together or to their mouth
- Reaches out with one hand while their other hand is in a fist
- Cannot stand while holding onto support
- Crawls lopsided
- Walking on toes
- Coordination and balance issues
If your child is showing one or more of the following signs it is important to discuss it with your child’s pediatrician.
Before we get into diagnosis and common tests, let’s look at the different types of cerebral palsy to know.
Different Types of Cerebral Palsy
You may be wondering how many types of cerebral palsy are there?
There are four types of cerebral palsy to know, with spastic diplegia being the most common type you will see and hear about.
When a child is diagnosed, the doctor categorizes the condition into one of these four main types:
- Spastic Cerebral Palsy
- Athetoid Cerebral Palsy
- Ataxic Cerebral Palsy
- Mixed Type Cerebral Palsy
The type of diagnosis is based upon the child’s mobility impacted as well as the number of limbs or body parts affected.
Let’s explore what you need to know about each of these types.
Spastic Cerebral Palsy
Commonly referred to as Hypertonic Cerebral Palsy, is the most common type of CP diagnosed in children affecting on average 70-80%.
Hypertonia, meaning increased muscle tone, tends to lead to painful limbs where muscles are noticeably stiff and tight making jerky movements.
Suffering from motor cortex damage to the brain (which controls voluntary body movements), a child may have difficulty walking, kicking a ball, moving their arm, or lifting objects.
Athetoid Cerebral Palsy
Also known as Dyskinetic Cerebral Palsy and it is the second most common type.
Marked by abnormal movements and muscle control in the arms, legs, and hands, makes this type of CP challenging controlling body coordination and mobility.
The uncontrollable movements tend to become more severe during times of emotional stress and will usually subside when sleeping or resting.
Ataxic Cerebral Palsy
Ataxia is the loss of control of full body movements and is the least common type of cerebral palsy impacting around 6% of children.
It is caused by damage to the center of the brain, the cerebellum, usually prior to birth commonly from:
- A brain bleed
- High blood pressure from the mother during pregnancy
- Problems with the placenta
The cerebellum when damaged results in poor coordination and lack of balance.
A child may appear unsteady and shaky in their arms and legs because their balance and depth perception is affected.
Mixed Type Cerebral Palsy
Is the result of multiple brain injuries that are located in numerous spots of the brain and result in affecting about 10% of children.
When a child shows signs of more than one type of CP, they will usually be diagnosed as a mixed type.
The most common mixed types of CP include a combination of spastic and athetoid.
The least common variety is the combination of ataxic and athetoid.
Keep in mind that each of these four types of cerebral palsy is diagnosed with common tests which lead us to our next topic.
Diagnosis and Common Tests
As mentioned before, a child immediately diagnosed with cerebral palsy right after birth is not as common but can happen.
Generally, the child not meeting developmental milestones alerts the parents and doctors that there may be deeper motor delay issues occurring. Which is the reason why cerebral palsy becomes diagnosed later while the child is growing usually between the ages of 1 to 2 years.
If the child is having leg movement difficulties (along with other early warning signs mentioned above), may point in the direction of spastic diplegia, but certain tests are performed to determine if a child has cerebral palsy.
Here are five common tests doctors run to check for brain damage and to rule out other conditions:
- Blood Test to identify cerebral palsy or rule out other conditions (like genetic disorders).
- CAT scan (CT scan) of the head to show if there is brain injury (which is similar to an x-ray).
- MRI of the head to check in detail for any neurological irregularity.
- Electroencephalogram (EEG) to look at the electrical activity in the brain.
- Cranial Ultrasound to show if there is bleeding in the brain.
The great news is there are numerous treatment options available to help your child live an all-out better quality of life if they are diagnosed with spastic diplegia cerebral palsy.
Even though cerebral palsy is not curable at this time, the condition does not worsen but can drastically improve with combined therapy and treatments.
The treatment your child needs really boils down to the signs and symptoms they are having.
Here are common treatments for cerebral palsy:
- Orthotic devices such as a walker, wheelchair, or leg braces help with independent mobility
- Physical therapy to improve motor functions and movement delays
- Occupational therapy allows a child to live an independent lifestyle by assisting them with their activities of daily living (ADL) like getting dressed, putting on shoes, or brushing their teeth
- Medications such as muscle relaxers to reduce muscle stiffness
- Orthopedic Surgery for those experiencing extreme pain in their movements and muscles to receive relief
- Stem Cell Therapy is still a very new treatment but this type of therapy is linked to restoring some movement functions for cerebral palsy patients
To Wrap It Up…
Cerebral palsy diagnosed in children ranges from mild to severe depending on where and how the brain damage occurred.
It is not a life-ending condition by any means it is actually quite the opposite!
Those with cerebral palsy have incredible abilities and are an inspiration to how we should live our lives in the most positive way.
I want to leave you with a post that shares ten incredible stories about people with cerebral palsy to tug on your heartstrings (it sure did ours)!
Recommended Guided Resources
If you need to learn more about cerebral palsy and the treatment options available to you, here are several guided resources we recommend.
An evidence-based guide for families who have a child with Spastic Diplegia Cerebral Palsy.
One of the best books to deal with the specific treatment of gait problems. This is a great resource if you work with or have a child with a gait disorder.
If you need a simple resource that provides a thorough overview of cerebral palsy and its treatment, this is a helpful reference to have on hand.
We want to wrap up by extending our gratitude to thank you for stopping by today!
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About the Author
Lindsey is the co-founder of The LENN Foundation and content creator of the Intensive Therapy for Kids blog.
When she isn’t busy playing Godzilla with her son or chasing around her mischievous Rottweiler pup, she loves creating experiences and memories with her loved ones (traveling, watching a good flick, trying new n’ yummy restaurants). Speaking of restaurants, one of her favs is Taco Bell!
Most of all, she is grateful for her supportive circle of family, friends, and to live out her passion for helping kids with Cerebral Palsy (like her sweet nephew Lenny).
If you’re curious about The LENN Foundation, you may see the kids’ helped and feel-good content here. ♥
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