Levels of Cerebral Palsy

Cerebral Palsy Diagnosis

multiple colorful levels, each with colored question mark in speech bubble

Different classification systems use varying criteria to describe the severity and type of cerebral palsy a person has. CP manifests itself in many different physical, intellectual, and mental health challenges, which complicates the process of establishing any universal standards. However, despite those challenges, it’s critical to have a thorough understanding of the kind and severity of your child’s cerebral palsy diagnosis when developing a treatment and intervention plan.

Is There a Universal Classification System for Cerebral Palsy?

When your child is diagnosed with cerebral palsy, you may hear varying terms regarding the level and severity. Different professions evaluate cerebral palsy from differing viewpoints, though they are all interested in determining the extent and severity of the condition. Here are some examples.

  • An orthopedic surgeon may evaluate how the patient’s limbs are impacted by cerebral palsy to determine appropriate treatment and therapies.
  • A neurosurgeon may assess the effects of CP on the brain and the extent of the damage.
  • School officials might evaluate cerebral palsy in terms of how it affects the child’s ability to function in a school setting and what special education supports might be necessary.

You might be interested in the classification of the disability, whether it is level 1 cerebral palsy or something more severe, to understand what to expect in the future.

What Are Some Common Classification Systems?

Scientists continue to work toward developing a universally accepted system of classification, and a few are being studied to at least standardize the research language. Such common ground would let researchers communicate clearly around topics such as life expectancy, social functioning, prevention strategies, and educational strategies. One example of a system under review is the Gross Motor Function Classification System.

In general terms, the most common classification systems are based on four types of criteria to determine the different levels of cerebral palsy.

Severity Level

The most common scales are mild, moderate, severe, or none. The categories are broad and have no specific criteria at each level. This type of classification gives a general idea of the extent of cerebral palsy in each patient.

  • Mild CP indicates that a patient can still move without assistance, and daily living activities are not impaired.
  • Moderate CP means that the patient needs assistive devices to carry out daily activities, such as braces and other adaptive technologies.
  • Severe CP diagnosis indicates that a patient needs a wheelchair and faces difficulty in carrying out daily activities.
  • No CP means that the patient has impairments consistent with cerebral palsy that appeared after the brain developed. Such impairments are considered the result of the incident that caused the CP.

Topographical Distribution

This classification of CP describes which parts of the body are affected and to what extent. The most common use for a topographical classification is in conjunction with the Motor Conjunction Classification System to develop a treatment plan. Two terms used in topographical classification are paresis and plegia (plegic). Paresis means weakened, while plegia means paralyzed.

  • Monoplegia or monoparesis means that only one body part is affected. This type of CP may be related to a form of hemiplegia or hemiparesis.
  • Diplegia or diparesis means that CP affects the legs or lower body more than arms.
  • Hemiplegia or hemiparesis describes a condition where the arm and leg on one side of the body are impaired.
  • Paraplegia or paraparesis refers to impairment of the lower half of the body, including both legs.
  • Triplegia or triparesis indicates that three limbs are impaired, such as two arms and one leg. It may also refer to impairment of the face and one upper and one lower limb.
  • Double hemiplegia or double hemiparesis means that all four limbs are impaired with a more significant impact on one side of the body than on the other.
  • Tetraplegia or tetraparesis means that all four limbs are involved with three more impaired than the fourth.
  • Quadriplegia or quadriparesis indicates that all four limbs are weakened.
  • Pentaplegia or pentaparesis means that all four limbs are affected along with the head and neck. Breathing and eating difficulties often accompany this type of impairment.

Motor Function

Classification based on motor function involves rating the impairment of the ability to control the body. The most common categories are spastic and non-spastic. There are varying levels of each, and they can occur together.

  • Spastic cerebral palsy involves increased muscle tone or hypertonia resulting in stiff limbs.
  • Non-spastic CP means decreased or inconsistent muscle tone or hypotonia, resulting in flaccid limbs.

Gross Motor Function

Classification based on gross motor skills uses five levels to describe the extent of the impairment. The higher the number, the greater the severity, so cerebral palsy level 3 would be the middle of the scale. Evaluations are made based on the age of the patient and what activities he or she can do independently.

With the help of comprehensive diagnosis and classification, you can better assist your child. If you think your child’s cerebral palsy is a result of medical malpractice, contact the Cerebral Palsy Family Lawyers at Janet, Janet & Suggs, LLC, and let us help you seek justice.



Reviewed by:
Trish Fletcher, MS, BSN, CRNP, NNP-BC, ALNC
Neonatal Nurse Practitioner | Birth Injury Legal Nurse Consultant

Tricia is a dedicated, focused, Birth Injury Legal Nurse Consultant and Neonatal Nurse Practitioner with more than 25 years of experience. Her strong clinical and critical thinking skills, paired with expertise caring for neonates in a Level III Neonatal Intensive Care Unit (NICU), ensures meticulous medical records review. READ FULL BIO

Was Your Child's CP Preventable?