Athetoid quadriplegic cerebral palsy is a subtype of cerebral palsy characterized by an inability to control muscle movement in the arms and legs. Athetoid cerebral palsy, which is also known as dystonic, choreoathetoid, or dyskinetic CP, results in out-of-control movements such as body writhing and jerky limbs. Rather than muscle paralysis, however, the type of quadriplegia involved in athetoid cerebral palsy denotes stiffness in all four limbs that produces the involuntary movements.

As many as 10% of children diagnosed with CP have non-spastic, athetoid cerebral palsy. Common symptoms include posture problems, stiff limbs, and floppiness in infancy. Athetoid CP features a combination of hypotonia (decreased muscle tone) and hypertonia (too much muscle tone), and it is these fluctuations in muscle tone fluctuations that create involuntary movements in the torso, face, arms, and legs.

Causes of Athetoid Quadriplegic Cerebral Palsy

Athetoid cerebral palsy is primarily caused by brain damage in the basal ganglia and/or cerebellum. The basal ganglia are the part of the brain responsible for regulating voluntary motor functions and eye movements while the cerebellum controls balance and coordination.

When these parts of the brain are malformed during fetal development or injured during or shortly after birth, athetoid quadriplegic cerebral palsy can develop.

Athetoid cerebral palsy can also be caused by:

• Maternal infections during pregnancy
• Misuse of forceps and other birth-assisting tools
• Accidents or head trauma
• Nuchal cord (when the umbilical cord wraps around the baby’s neck, cutting off oxygen)
• Severe, untreated jaundice
• Negligent medical professionals
• Premature birth
• Low birthweight
• Multiple gestation pregnancy

Newborns are especially vulnerable to head trauma during their first month of life. Accidentally dropping a newborn or getting into a car accident can leave an infant with permanent damage to the parts of the brain that control motor functions and movement.

Diagnosis

Athetoid cerebral palsy is commonly diagnosed no earlier than nine months of age, when a baby starts to exhibit signs of developmental delays. Parents may notice involuntary jerking motions, tremors, a lack of coordination, and trouble balancing.

When diagnosing a child with cerebral palsy, most physicians use the Gross Motor Function Classification System (GMFCS). The GMFCS is a five-level classification system used to describe the child’s voluntary movements such as sitting and walking.

Currently, the GMFCS levels are:

• Level I: The child can walk independently, climb stairs without using a railing, and perform certain gross motor skills. Balance, speed, and coordination, however, are limited.
• Level II: The child can climb stairs using a railing and may have trouble walking long distances. They may require physical assistance or a mobility device in certain circumstances. Gross motor skills such as running and jumping are limited.
• Level III: The child needs a hand-held mobility device in most indoor settings and may need a wheelchair for maneuvering longer distances.
• Level IV: The child may walk short distances at home with assistance, but typically needs a body support walker or powered mobility aid. Outdoors, a manual or powered wheelchair is typically required.
• Level V: The child is transported in a wheelchair in all settings and is limited in their ability to maintain head and trunk positions or control limb movements.

Treatments for Athetoid Quadriplegic Cerebral Palsy

There are many treatment options available for athetoid quadriplegic CP, including:

• Physical and occupational therapy
• Rehabilitation
• Mobility devices
• Speech therapy
• Medications

Physical and occupational therapy are a must for children with CP because these therapies help them improve gross motor skills and complete basic daily activities.

Surgical Considerations

As with any form of cerebral palsy, surgery is a last resort treatment. In instances where orthopedic surgery can benefit the patient, the right procedure can alleviate muscle stiffness and pain.

The Child with Athetoid Quadriplegic Cerebral Palsy

Children with athetoid quadriplegic CP may experience:

• Unsteadiness
• Drooling
• Tremors
• Grimacing
• Abrupt or slow, writhing movements
• Involuntary torso twisting
• Pain when moving
• Awkward reflexes
• Lack of coordination
• Too-slow or too-fast movements
• Difficulty with fine motor skills

Since athetoid quadriplegic CP affects both the arms and legs, many of these symptoms will be apparent throughout the entire body. In severe cases, a child with athetoid CP may experience learning difficulties, although others do not.

Children who have trouble getting around due to their involuntary movements or tremors often benefit from mobility devices outside the home, even if they can walk relatively independently at home. Receiving a proper diagnosis early can help your child get the therapies and treatments needed to set them on the right track both at school and beyond.

No parent expects their child to be born with athetoid quadriplegic cerebral palsy. If you suspect your child was injured as a result of medical negligence or malpractice during or shortly after delivery, the Cerebral Palsy Family Lawyers at Janet, Janet & Suggs LLC can help. Contact us today to learn how we can support your family.

Reviewed by:
Claire Surles, RN
Registered Nurse

Claire comes to JJS after a 10-year career as a labor and delivery nurse. She dedicated her hospital efforts to advocating for families, providing the safest birthing environment possible as Newborn Admission Nurse at UMMC St. Joseph Medical Center in Towson, Maryland. Her passion for helping those who experienced losses at any stage of gestation led to her appointment as Coordinator of the hospital’s ROOTS perinatal loss program. READ FULL BIO

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