The National Institute of Neurological Disorders and Stroke (NINDS) defines cerebral palsy as “a group of neurological disorders,” indicating that there are different types of this particular disease. However, these types can be broken down in different ways.
One is based on when the cerebral palsy (CP) first begins, or the timing of its onset. The second way involves identifying the location of the movement-related issues. The third way of categorizing type requires thinking of CP from a diagnosis standpoint.
Let’s discuss all of these now.
Cerebral Palsy Type Based on Onset
When determining the type of cerebral palsy that exists based on its onset, there are two options: congenital cerebral palsy and acquired cerebral palsy.
Congenital cerebral palsy occurs as a result of abnormal brain development or brain damage that is either sustained prior to or during the birth process. This type of CP is the most common, with the Centers for Disease Control and Prevention (CDC) indicating that 85 to 90 percent of all CP cases fall into this category.
The second type of cerebral palsy based on onset is acquired cerebral palsy, which occurs when there is damage to the brain 28 or more days after the child’s birth. These cases of CP are generally a result of infection or injury to the child’s head region.
Acquired cerebral palsy may also occur if blood flow to the newborn child’s brain is somehow inhibited or impacted. This could happen if the child has a heart defect, blood clotting issues, improperly formed blood vessels, or sickle cell disease.
Cerebral Palsy Type Based on Location
Because cerebral palsy can affect various areas of the body, sometimes its “type” is labelled based on this factor. The different options based on physical location of the CP include:
- Monoplegia – CP that impacts one arm or leg.
- Diplegia – CP that impacts two limbs.
- Triplegia – CP affecting three limbs (such as both legs and one arm or both arms and one leg).
- Quadraplegia – CP affecting both arms and both legs.
- Hemiplegia – CP that impacts one side of the body.
- Double hemiplegia – CP in which all four limbs are impacted, but the arms are affected more so than the legs.
Cerebral Palsy Based on Type or Diagnosis
The other way to look at cerebral palsy type, or form, is based on the actual medical diagnosis. This is similar to how a diabetic can be type 1 or type 2. Both are forms of the underlying disease, but each one occurs for different reasons and, thus, requires a different treatment route.
In the case of CP specifically, there are four main types of diagnoses. They are:
Spastic cerebral palsy. The CDC shares that this type of CP is the most common, accounting for approximately 80 percent of all cerebral palsy cases. Characterized by stiffening of the muscles combined with awkward movements, spastic cerebral palsy can be broken down into three different types based primarily on what areas of the body it affects.
- Spastic hemiplegia/hemiparesis. This type of spastic CP generally impacts just one arm and hand, with the affected arm usually being thinner and shorter than the other. Spastic hemiplegia can also sometimes impact a leg, but this isn’t as common. Individuals with hemiparesis may develop scoliosis and/or seizures, and though speech will likely be delayed, there is usually no impact on level of intelligence.
- Spastic diplegia/diparesis. Where spastic hemiplegia often affects the upper body, individuals with spastic diplegia, also referred to as diparesis, have more noticeable effects in their lower extremities. These can include muscle stiffness in the legs and leg hyperactivity. An individual with this type of CP often has a “scissored” type of gait, which involves walking with inverted knees that tend to cross. With spastic diplegia, intelligence is usually the same as it is for those without CP, as are skills related to language.
- Spastic quadriplegia/quadriparesis. The third type of spastic CP is spastic quadriplegia, or quadriparesis, and it impacts the entire body. The NINDS indicates that this type of CP is the most severe in that the individual usually cannot walk, has stiff limbs, and has minimal neck control. Additionally, someone with spastic quadriplegia often has difficulty speaking and a “moderate-to-severe intellectual disability” is likely. Seizures may also be present with this form of CP.
Dyskinetic cerebral palsy. Sometimes referred to as athetoid cerebral palsy, the most notable characterizations associated with dyskinetic CP include uncontrollable movements associated with all extremities—the hands, feet, arms, and legs—which can make sitting and walking more difficult. Additionally, individuals with dyskinetic CP may notice that their muscle tone varies not only daily, but sometimes by the hour or minute.
Individuals diagnosed with dyskinetic cerebral palsy will typically drool, grimace, or have issues swallowing or sucking due to uncontrollable facial muscle movements. In some cases of dyskinetic CP, there may be difficulties associated with hearing, breathing, and speaking, though intelligence is usually not impacted.
Like with spastic CP, dyskinetic cerebral palsy can also be broken down into other types. These include:
- Choreoathetoid cerebral palsy. MedicineNet explains that choreoathetoid CP generally involves decreased muscle tone, minimal contraction of the arms and legs, and uncontrollable movements brought on by stress or “normal emotional reactions such as laughing.”
- Dystonic cerebral palsy. With dystonic CP, the individual will likely experience slow movement, stiff muscles, and “persistent abnormal postures that relax after seconds or minutes” according to MedicineNet, though to a lesser degree than for individuals with choreoathetotic CP. Muscle tone is typically higher with dystonic CP as well.
Ataxic cerebral palsy. Ataxic cerebral palsy is CP that creates difficulties related to walking and coordination, because it impacts depth perception and balance. Individuals with ataxic cerebral palsy may find it harder to perform exact movements, such as those required to color a picture or unlock a door with a key. They may also have difficulties with other types of self-initiated movements, like grabbing for a blanket or brushing their hair.
Mixed types of cerebral palsy. This type of CP diagnosis occurs when the individual’s symptoms don’t entirely match just one type of cerebral palsy, but are more of a combination. The CDC reports that the most common type of mixed cerebral palsy is spastic-dyskinetic.
The type of cerebral palsy, its location, and severity will determine which treatment route is best.