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Spastic Diplegia Cerebral Palsy

Cerebral palsy is a term used to illustrate a cluster of chronic conditions affecting body movement and muscle coordination. It is caused by trauma to one or more specific areas of the brain, most likely occurring during fetal development; before, during, or shortly after birth; or during infancy. Therefore, these disorders are not caused by problems in the muscles or nerves, but instead, faulty development or damage to motor areas in the brain disrupt the brain's ability to properly control movement and posture. Depending on the area of the brain in which trauma occurred, the affects of the condition will vary.

A form of cerebral palsy, called spastic cerebral palsy, is caused when the brain damage occurs in the outer layer of the brain, the cerebral cortex. Spastic cerebral palsy is the most common form of cerebral palsy, affecting 70 to 80 percent of patients. Spastic cerebral palsy symptoms include increased tone, or tension, in a muscle. Normal muscles work in pairs; when one group of muscles contract, the other group relaxes. This allows uninhibited movement in the desired direction. Due to complications in brain-to-nerve-to-muscle communication, the normal degree of muscle tension is disrupted. Muscles affected by spastic cerebral palsy become active together and block effective movement. This causes the muscles in spastic cerebral palsy patients to be constantly tense, or spastic. Cerebral palsy can be classified by the way it affects movement or by the number of limbs it affects. These classifications can be combined to describe severe conditions such as spastic diplegia cerebral palsy. In spastic diplegia cerebral palsy all four limbs are affected; both legs, as well as mild affects in the arms are present.

Back in the 1860s, an English surgeon named William Little wrote the first medical descriptions of a puzzling disorder that affected children in the first years of life, causing stiff, spastic muscles in their legs and to a lesser degree, their arms. These children had difficulty grasping objects, crawling, and walking. They did not get better as they grew up nor did they become worse. Their condition, which was called Little's disease for many years, is now known as spastic diplegia cerebral palsy.

Spastic diplegia cerebral palsy tends to affect the legs of a patient more than the arms. Spastic diplegia cerebral palsy patients have more extensive involvement of the lower extremity than the upper extremity. This allows most people with spastic diplegia cerebral palsy to eventually walk. The gait of a person with spastic diplegia cerebral palsy is typically characterized by a crouched gait. Toe walking and flexed knees are common attributes and can be corrected with proper treatment and gait analysis.

In many cases the IQ of a person with spastic diplegia cerebral palsy may be normal. However, other side effects like strabismus are common. Strabismus, the turning in or out of one eye, commonly called cross-eye, affects three quarters of people with spastic diplegia cerebral palsy. This is due to weakness of the muscles that control eye movement. In addition, these individuals are often nearsighted. If not corrected, strabismus can lead to more severe vision problems over time.

Specialized treatment teams for individuals with spastic diplegia cerebral palsy can help decide which treatments are best suited for them. Treatments such as leg braces, gait analysis, botox injections, hyperbaric oxygen treatment, and several other treatments can help to manage spastic diplegia cerebral palsy. Treatment teams should include a physical therapist, pediatrician, physiatrist, neurologist and neurosurgeon, and an orthopedic surgeon that can all aid in the decision making process.

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