Ataxic Diplegic Cerebral Palsy
Ataxic diplegic cerebral palsy is a mixed form of cerebral palsy that results in traits from both ataxic and diplegic CP. Ataxic cerebral palsy affects motor function, balance, and coordination. As a result, children with ataxic CP struggle with controlling their movements or even their speech. Diplegic cerebral palsy, which is also known as spastic diplegia, is characterized by spasms and tense muscles. The leg muscles, in particular, tend to become tighter over time, reducing a child’s range of motion, but diplegic CP can affect any limb or joint, even leading to hip disease and dislocations.
A child with ataxic diplegic CP exhibits symptoms from both of these cerebral palsy types. They may not only struggle with balance and depth perception, but their muscles and joints may also be stiff to the point that they experience a reduced range of motion.
Causes of Ataxic Diplegic Cerebral Palsy
Ataxic CP is typically caused by an injury to the brain’s cerebellum before, during, or shortly after birth. Neonatal asphyxia, or oxygen deprivation during delivery, is the most common cause of diplegic CP.
When both ataxic and diplegic cerebral palsy occur, the person in question has usually suffered both brain damage and oxygen deprivation. In some cases, maternal infections such as rubella or a high-grade fever during pregnancy can cause the condition. Premature delivery, low birth weights, and multiple babies during one pregnancy also increase the risk of cerebral palsy.
Diagnosis
Oftentimes, cerebral palsy isn’t suspected until a child falls behind in developmental milestones. Parents may notice their child struggling or failing to crawl, walk, or perform basic motor functions. At that point, your child’s pediatrician might review their history, order imaging tests, and perform a physical examination using the Gross Motor Classification System to characterize their physical abilities and weaknesses.
This multi-level categorization technique helps identify someone’s level of severity with cerebral palsy based on their age, performance, and gross motor function. Once the physician makes a determination, the patient’s GMFCS level can help medical personnel, parents and caregivers better understand the patient’s needs, develop therapy plans, and make the appropriate lifestyle adjustments.
The five GMCS levels are:
- Level I: Functional gross motor skills are present, but the patient struggles with speed, coordination, and balance. They can move independently without mobility aids.
- Level II: The patient may need assistance with uneven or inclined surfaces but otherwise doesn’t need any adaptive equipment.
- Level III: The patient requires hand-held mobility aids and may need a wheelchair to travel long distances or on uneven, inclined surfaces.
- Level IV: The patient is only self-mobile with significant assistance. They may require a powered wheelchair or other forms of adaptive equipment.
- Level V: The patient experiences limitations that impair all forms of movement, resulting in an extreme dependency on assistive technology, adaptive equipment, and caregivers.
When diagnosing ataxic diplegic cerebral palsy, characteristics from both ataxic CP and diplegic CP must be present regardless of the patient’s determined GMCS level. This may mean additional testing, such as an MRI, CT scan, ultrasound, blood test, electroencephalography, or electromyography.
Treatments for Ataxic Diplegic Cerebral Palsy
Physical and occupational therapies that focus on boosting and retaining the range of motion are key in treating ataxic diplegic CP. Strength-training exercises help improve motor skills and balance, while occupational therapy helps children perform basic daily functions, such as eating and dressing. Some children may also require braces or other devices to assist bone development. Those with stiff muscles can also benefit from massage as early as infancy.
Certain medications may also help treat ataxic diplegic CP. Intrathecal baclofen, for instance, can ease pain and relax muscles.
Surgical Considerations
When stiffness and spasticity are severe enough to impact movement or produce pain, orthopedic surgery may be beneficial. Doctors use computerized diagnostic techniques to analyze the patient’s gait and locate the precise muscles that can benefit from surgery.
Keep in mind, however, that age is an important consideration for surgery. The optimal age to correct spasticity with surgery is between 2 and 4 years of age, but the best time frame to lengthen Achilles tendons or hamstrings is between 7 and 8.
The Child With Ataxic Diplegic Cerebral Palsy
Common medical issues and symptoms associated with mixed forms of cerebral palsy include:
- Cognitive issues
- Seizures
- Hearing problems
- Difficulty swallowing and speaking
- A mixture of loose and spastic movements
- Involuntary movements with stiff muscles
- Vision problems such as cortical blindness and amblyopia (“lazy eye”)
- Facial grimaces and drooling
Some children may skip crawling altogether or pull themselves around with their forearms. They may also prefer sitting in a “W” position, which can cause hip or gait problems.
Despite incredible advances in medical treatments, cerebral palsy can have a huge emotional and financial impact on families. If you think your child’s CP is a result of medical malpractice, you may be eligible for compensation. Contact the Cerebral Palsy Family Lawyers at Janet, Janet & Suggs, LLC today to learn more.
Giles H. Manley, M.D., J.D., F.A.C.O.G. | CPFN Medical Advisor
Board-Certified OBGYN | Medical Malpractice Attorney
Dr. Manley has delivered over 2,000 babies and uses his wealth of medical knowledge to uncover medical errors that were missed by others (keep in mind most CP cases involve errors committed at or around the time of birth). READ FULL BIO
