Athetoid diplegic cerebral palsy is a classification of cerebral palsy that characterizes an inability to control muscle movement in the lower extremities. Athetoid cerebral palsy, also known as choreoathetoid, dystonic, or dyskinetic CP, causes individuals to exhibit movements out of their control, such as jerky limbs or slow writhing. Diplegia, or diparesis, is a subset of CP in which the legs are the most affected limbs.

Only a small number of children diagnosed with cerebral palsy have athetoid CP. This type of CP features a mixture of hypotonia (decreased muscle tone) and hypertonia (too much muscle tone), causing muscle tone fluctuations that create involuntary movements in the face, limbs, and torso. Children with this type of CP may have posture problems, loose limbs, stiff limbs, or even feeding issues. When diplegia is present, however, the upper body isn’t affected like the legs and feet, so most of these issues are contained to the lower body.

Causes of Athetoid Diplegic Cerebral Palsy

Athetoid cerebral palsy is caused by damage to the brain’s cerebellum and/or basal ganglia. The cerebellum is responsible for controlling coordination and balance, while the basal ganglia regulate eye movements and voluntary motor functions.

Athetoid cerebral palsy can stem from malformations or interruptions during fetal brain development. Injury can also occur during a complicated birth or shortly after birth.

Other common causes of athetoid CP include:

• Misuse of birth-assisting tools such as forceps
• Maternal infections
• Severe, untreated jaundice
• Accidents or trauma
• Oxygen deprivation during birth
• Low birthweight
• Physician negligence
• Premature birth

For example, a car accident within the first month of a newborn’s life can damage the basal ganglia. In some cases, injuries sustained during birth could have been preventable, especially when they occur as a result of medical negligence.

Diagnosis

Children with athetoid CP can be diagnosed around 9 months of age, though many doctors wait until children are 18 to 24 months to make firm diagnoses. At this age, parents and physicians can identify any delays in developmental milestones. Oftentimes, the first sign is when a parent begins to notice issues with coordination and balance and jerky movements.

After suspecting developmental delays, it’s important to ask your doctor about performing clinical examinations and tests. Like all types of CP, athetoid diplegic is an irreversible, lifelong condition. Even so, the condition’s severity does not increase over time or limit a person’s life expectancy like the more severe types of cerebral palsy can. The key is pursuing adequate treatment early and often to improve your child’s quality of life.

Treatments for Athetoid Diplegic Cerebral Palsy

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

• Physical therapy
• Occupational therapy
• Rehabilitation
• Braces
• Medications

For instance, physical therapy and occupational therapy aim to improve gross motor skills and make daily activities easier. Physical therapy focuses on strengthening the right muscles, while occupational therapy teaches a child how to perform basic tasks, such as feeding and dressing. The right mobility devices can also help since diplegic forms of CP usually affect the lower extremities.

Speech therapy is recommended when a child experiences issues swallowing or breathing.

Alternative therapies such as acupuncture, yoga, and massage therapy may help ease the symptoms of athetoid CP and should only be used in conjunction with medically recommended therapies. Speak with your doctor to learn more about alternative therapies.

Overall, treatment for athetoid diplegic CP should address existing symptoms while preventing future complications that may occur later in life. Many people with mild forms of athetoid CP who receive the proper therapies and treatment options can go on to live relatively independent lives as adults.

Surgical Considerations

Surgery is generally considered a last resort for treating cerebral palsy. When orthopedic surgery is recommended, it’s because muscle stiffness and spasticity have become severe enough to make walking or moving painful or difficult.

The Child with Athetoid Diplegic Cerebral Palsy

Since a damaged cerebellum and basal ganglia can’t properly signal the body’s involuntary reflexes, a child with athetoid CP may experience:

• Tremors
• Drooling
• Grimacing
• Slow, writhing movements
• Unsteadiness
• Abrupt movements
• Twisting of the torso
• Poor posture
• Awkward reflexes
• Pain during movement
• Lack of coordination
• Too slow or too fast movements
• Issues with fine motor skills

With athetoid diplegic CP, these issues may only be present in the hips, legs, and feet. Someone with this subset of CP may or may not experience learning difficulties. The common factors among athetoid CP sufferers are very weak muscles and uncontrollable movements. Many children without learning difficulties who can utilize mobility equipment, such as braces or wheelchairs, find it easy to adapt in a normal classroom environment.

Athetoid diplegic cerebral palsy is a challenging condition that can take an emotional and financial toll on a family. If you believe your child was injured because of medical negligence or malpractice, the Cerebral Palsy Family Lawyers at Janet, Janet & Suggs, LLC can help your family examine your options and determine whether you have a legal case. Contact us today.

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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