Ataxic hemiplegic cerebral palsy is a relatively rare mixed form of CP that not only affects an individual’s balance and coordination but also their muscle tone and motor abilities on one side of the body.

Ataxic cerebral palsy is caused by brain damage to the cerebellum and affects about 5 to 10% of those with CP. Symptoms include a lack of depth perception, coordination, and balance. Hemiplegic cerebral palsy is a form of paralysis affecting one side of the body. It is also known as unilateral cerebral palsy, hemiparetic cerebral palsy, or hemiplegia. Combined with ataxic cerebral palsy, an individual may have more difficulty coordinating and controlling movements on one side of the body, or the affected side may be paralyzed altogether. Children with ataxic hemiplegic CP require a precise diagnosis and specific treatment plan.

Causes of Ataxic Hemiplegic Cerebral Palsy

In most cases, injury to the brain’s cerebellum before, during, or shortly after birth is the primary cause of ataxic cerebral palsy. Situations or birth injuries that can cause ataxic CP include:

• Multiple gestations
• Low birth weight
• Premature birth
• Placental abnormalities
• Blood clotting
• Infections
• Loss of blood flow or oxygen to the baby’s brain
• Prenatal drug use
• Adverse effects from surgery or drugs during delivery
• Improper medical care
• Failure to treat severe jaundice in a newborn
• Not performing a medically advised C-section
• Issues with the umbilical cord

By contrast, hemiplegic CP is mostly caused by a fetal or neonatal stroke. Strokes in newborns can result from:

• Birth trauma
• Hypoxic-ischemic encephalopathy
• Preeclampsia

In some cases, these strokes are preventable and occur as a result of medical negligence, which is why many families seek legal help.

Diagnosis

Typically, doctors won’t diagnose ataxic cerebral palsy until a child suspected of having the condition is around 18 to 24 months old. During this time frame, parents and pediatricians are better able to identify issues with normal developmental milestones. In fact, some parents may not even suspect CP at all until their baby’s motor skills fail to develop. As soon as you suspect your child may be falling behind in their development, ask your doctor about doing an early assessment, including a developmental screening.

While ataxic CP may take some time to identify, hemiplegic CP is often more noticeable at an early age. Many infants who develop hemiplegic CP have seizures, and those seizures can serve as an early warning sign. A baby with hemiplegic CP may also exhibit the following signs:

• Stiff muscles on one side of the body
• Delayed milestones (i.e., rolling over, crawling, sitting upright, walking, etc.)
• Trouble balancing
• Asymmetrical movements when crawling or standing with assistance
• A preference for using one hand (the affected hand may remain clenched into a fist)

After a physician suspects ataxic hemiplegic cerebral palsy, they can confirm the diagnosis with magnetic resonance imaging (MRI) or a cranial ultrasound. They may also use the Gross Motor Function Classification System to better characterize and understand the child’s physical abilities and weaknesses. The GMFCS is divided into five levels that classify a child’s CP symptoms, with Level I being mild and Level V being severe.

Treatments for Ataxic Hemiplegic Cerebral Palsy

While some children with hemiplegic CP are severely affected by the paralysis, 88% fall into the GMFCS Level I category, which means that they’re only mildly affected. Ataxic hemiplegic CP is complicated, however, and no two children with the condition are the same.

Since many children experience an unsteady gait, trouble grasping objects, movement overcorrection, speech problems, and other issues in addition to weakness or paralysis on one side, treatment involves a mixture of therapies.

Physical and occupational therapy are considered the main treatments for ataxic hemiplegic cerebral palsy. Physical therapy focuses on strength and flexibility exercises as well as massage therapy and orthotic devices, which help children improve their balance and stability. Occupational therapy addresses balance and coordination issues by increasing upper body strength and focusing on completing daily tasks with assistive devices.

Overall, these therapies are designed to help a child with cerebral palsy become more independent as they get older.

The Child with Ataxic Hemiplegic Cerebral Palsy

Children with milder forms of ataxic hemiplegic cerebral palsy may be able to walk on uneven surfaces, sit or stand without support and climb stairs without handrails by age 6. However, they may experience some challenges:

• Uneven gait that causes tripping
• Difficulty turning their affected hand over or grasping objects with the affected hand
• Sensory loss or vision problems on one side
• Epilepsy
• Scoliosis
• Muscular atrophy on the weakened side
• Speech and language problems
• Behavioral issues
• Cognitive impairments

Ataxic hemiplegic cerebral palsy can take an emotional and financial toll on a family. If you think your child’s CP is the result of medical malpractice, you may have the option of pursuing financial compensation from negligent parties. Contact the Cerebral Palsy Family Lawyers at Janet, Janet & Suggs, LLC. We’ll help your family understand your rights and options.

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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