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Neuromuscular Impairments of Cerebral Palsy

By definition, cerebral palsy is a neuromuscular disease, affecting both the nerves and muscles of the cerebral palsy sufferer.  Identifying which individual neuromuscular impairments a person with cerebral palsy has or doesn’t have is they key in making both a diagnosis and a treatment or a therapy plan.  These kinds of impairments include spasticity and rigidity, athetosis, ataxia, and hypotonia.  Being a group of disorders rather than just one, cerebral palsy victims may exhibit some, none, or all of these neuromuscular impairments.

Spasticity occurs in a large number of people with cerebral palsy, some 70-80% of all cases.  The neuromuscular impairment of spasticity includes severe muscle contraction when the muscle is stretched.  Spastic cerebral palsy usually manifests itself in increased muscle tone and muscular stiffness.  Movement can be very awkward to severely disabling.

Athetoid or dyskinetic cerebral palsy symptoms occur in some 25% of people with cerebral palsy.  People with atheosis experience uncontrolled slow twisting or writing of their bodies.  These movements usually are manifested in the hands, arms, feet, and legs, but can occur in any or none of these limbs.  Occasionally there will be neuromuscular impairment of this type in the facial region or the tongue.  Speech under these conditions is affected.

Some 5-10% of cerebral palsy suffers have ataxic symptoms.  Ataxia is most characterized by a loss of balance, or problems with depth perception.  Ataxia can affect the person’s walking ability especially, causing unsteady or uncontrolled gait.  Ataxia can also be exhibited when movements necessitating control (like drinking from a cup, or writing) are necessary, and can be disabling when individuals attempt them.  Muscle tone can be either increased or decreased. 

Hypotonia occurs when all muscles are flaccid and the child has little or no movement or ability to control movement at rest.  This type of neuromuscular disability associated with cerebral palsy is very rare, but also extremely disabling.  The child feels limp when held and usually doesn’t rest on their elbows or bend their knees.

It is important to have a correct and early diagnosis so that the most effective treatments and therapies for cerebral palsy can begin at once.  Regardless of which types of neuromuscular groups are most affected, the therapies all must be consistent and take place over a long period of time.  Healthcare professionals are usually trained in making these diagnoses early, but it is often difficult to do. Sometimes misdiagnosis of these neuromuscular impairments can lead to further problems in the future.

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