Types of cerebral palsy

Cerebral palsy develops as a result of changes or injury to the developing brain, which is why it is described as a neurological condition. While its effects begin in the brain, cerebral palsy is most often noticed through the way it influences movement, posture and coordination. In this article we explore:  

• Types of cerebral palsy, including spastic, dyskinetic and ataxic 

• The key characteristics and symptoms associated with each type 

• Common causes and contributing factors linked to cerebral palsy 

• Treatment, therapy and ongoing support options for cerebral palsy 

Types of cerebral palsy 

Cerebral palsy is a condition caused by damage to the brain so is primarily classed as a neurological condition. However, it’s most obvious effects on the body are an impairment of movement, posture and coordination, so it is also considered an orthopaedic and neuromuscular condition. 

The brain is either damaged or develops abnormally, often before birth, and cerebral palsy mostly afflicts children under three years old. The brain damage or abnormalities do not progress with age, meaning that cerebral palsy is a ‘static’ condition where the brain damage does not get any worse or improve as time goes on. However, some of its effects on the body may become slightly more or less pronounced over time. 

It is not a single condition and there is no clear and singular cause, therefore no two cases of cerebral palsy are exactly the same, making it difficult to study and categorise. On the one hand, it can affect some people mildly, but for others it can be very severe and debilitating. 

There can also be some incapacitating secondary complications from cerebral palsy such as 

• Epilepsy 

• Learning difficulties 

• ADHD  

• Loss of hearing 

Spastic cerebral palsy 

Of the three main categories, spastic cerebral palsy is the most common, affecting just under 80% of all people with the condition. It is the result of an abnormality in the brain called an upper motor neuron lesion, which prevents the brain from sending some necessary electrical signals to the muscles. In severe cases, its effects are noticeable enough to be diagnosed within the first year of life. However, children with milder symptoms may go undiagnosed until reaching three years of age. 

Spastic cerebral palsy is characterised by stiff and jerky movements in affected areas, and the parts of the body that this involves classifies the condition further: 

• Hemiplegia – this is when one side of the body is affected, the leg and arm in particular 

• Diplegia – this is when the lower half of the body is predominantly affected. The arms are either not affected, or are slightly affected at most 

• Quadriplegia – in this case both the arms and the legs are affected, the arms usually more so than the legs 

Less commonly, there are also the following two (very rare) types: 

• Monoplegia – where one limb is affected 

• Triplegia – where three limbs are affected 

Using this categorisation method, two examples would be spastic diplegic cerebral palsy or spastic quadriplegic cerebral palsy 

Athetoid dyskinetic cerebral palsy 

Much less common than spastic cerebral palsy, athetoid cerebral palsy is estimated to affect between 10 to 20% of all people with the condition and is usually diagnosed within 6-24 months of birth. 

Athetoid cerebral palsy, also sometimes known as dyskinetic cerebral palsy, occurs through damage to the basal ganglia, a part of the brain that controls coordination and movement. This results in an alternation between both excessive muscle tone (a stiffness of the muscles known as hypertonia) and low muscle tone (a weakness in the muscles called hypotonia), which causes involuntary slow and writhing movements in the limbs and trunk of the body. 

Athetoid dyskinetic cerebral palsy has two further sub-category groups: 

• Choreoathetoid cerebral palsy: where involuntary movement and spasms primarily affect the extremities and the face.  

• dystonic cerebral palsy (where dystonia occurs i.e. slow and writhing contractions that are more pronounced either in isolated regions or alternatively, across the whole of the body). 

Generally, as severe cases tend to affect several areas of the body, including all limbs, the face and the trunk, athetoid cerebral palsy can often be classified as athetoid quadriplegic cerebral palsy. 

Holly’s story offers a clear example of dyskinetic (choreoathetoid) cerebral palsy, a form characterised by involuntary and fluctuating movements that can affect coordination and speech. As a result of oxygen deprivation at birth, Holly experiences significant physical and communication challenges, yet her cognitive ability is unaffected which is an important and often misunderstood aspect of dyskinetic cerebral palsy. Holly’s journey helps challenge common misconceptions and illustrates how this type of cerebral palsy can present very differently from person to person, reinforcing the importance of seeing the individual, not just the diagnosis. 

Ataxic cerebral palsy 

Ataxic cerebral palsy is the least common of the main categories and is relatively rare, affecting approximately 3.8% of all children with cerebral palsy. 

It is usually developed either prior to or during birth and is the result of complications during pregnancy causing damage to the cerebellum, a region at the base of the brain vital for motor control. However, ataxic cerebral palsy can also occur after illnesses such as meningitis or a severe head trauma. 

Ataxic cerebral palsy causes tremors and difficulties in walking, of which will be discussed further in the effects of cerebral palsy section. 

Mixed cerebral palsy 

Although there are three main categorisations of cerebral palsy, it is not uncommon for there to be a combination of two or more of the categories present at the same time. These cases are called mixed cerebral palsy. 

For example, the most common mixed form is the muscle-tightening spastic cerebral palsy combined with the involuntary movements of athetoid cerebral palsy. This is the result of injuries to two parts of the brain known as the pyramidal and extrapyramidal areas. 

Although spastic athetoid cerebral palsy is the most common of the mixed category, various combinations are possible, with athetoid and ataxic mixed cerebral palsy the least common. 

Cerebral palsy negligence solicitors 

Every case of cerebral palsy is unique, just as every birth, every baby and every family is. At Fletchers, we recognise that behind every diagnosis is a deeply personal story shaped by individual circumstances, challenges and strengths. This understanding sits at the heart of how we support families; by listening first, and by taking the time to truly understand each child’s needs rather than making assumptions based on labels or classifications.  

Our expert medical negligence team uses this level of understanding to advocate for the needs of your child and family, ensuring that the outcome of your claim not only supports medical needs, but quality of life needs also. Contact our team today.