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Jeff Brody
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Muscular Impairments Relating to Cerebral Palsy

Muscular impairments are usually the primary symptom in a person suffering from cerebral palsy.  Since cerebral palsy is a grouping of motor related problems, rather than one single symptom, muscular impairments may be just a part of the whole disease.  Symptoms involving muscle impairments in children with cerebral palsy may develop, change, or even get worse as the child gets older. 

The affected muscles can be anywhere from one part of the body, one side of the body, or even the entire body.  Spasticity, or an uncontrolled movement and muscle tension, may occur either slightly or severely, depending on the person with cerebral palsy.  Mild symptoms of muscle impairments include something as fairly benign, and possibly overlooked, as a clumsy sort of walk.  Symptoms in the muscles can also range in the severe as well, with the person being unable to control any movement in their arms, legs, mouth, and tongue.

Subdivisions in cerebral palsy definitions are usually based on which parts of the body are most affected.  There are many variations on these terms and overlapping diagnoses but most doctors use three main ones when discussing patients with cerebral palsy:  hemiplegia, diplegia, and quadriplegia.

Hemiplegia involves the muscle impairment of one arm and one leg on the same side of the body.  Hemiplegia is the least impairing type of cerebral palsy, and may only involve one limb.  Double hemiplegia is a term used for persons with cerebral palsy who are affected in four limbs but in two different ways (the left might spasm and the right side may be limper).  Hemiplegics may only be slightly affected, and can go on to have normal intelligence and lives.

Diplegia is used to describe cerebral palsy patients who are affected in both legs only.    The arms of the diplegic may also be affected, but usually are less so.  Diplegics usually have difficulty walking, have some form of spasticity, and have the possibility of having hip problems.  Some delay or unevenness in muscle growth may develop into shorter or uneven legs, which may stiffen the joints and diminish the child’s range of motion. 

Quadriplegia refers to the muscle impairment of all four limbs and usually trunk and neck muscles as well.  Quadriplegia, like all forms of cerebral palsy, has a range of severity that may go from moderate to severe muscle impairment.  Moderate quadriplegics are able to sit still, walk with the aid of a walker, and can feed themselves.  Severe quadriplegia may involve not being able to walk or sit, not able to get themselves into and out of wheelchairs or other devices, not able to feed themselves, and have frequent uncontrolled muscle spasms and movements.  The quadriplegic also may have serious mouth muscle related issues, making speech and eating difficult on their own.
Making a diagnosis on which type of muscle problem a child with cerebral palsy has is important and difficult.  Consistent testing is key in making a correct diagnosis.  If someone is misdiagnosed, incorrect treatment may be administered, which may cause symptoms to get worse.  When the correct diagnosis is finally made, it may take even longer to get better, and may necessitate additional therapies or treatments.

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