Athetoid Cerebral Palsy
Cerebral Palsy is the umbrella term for brain damage. The neurological disorders that can result are many and varied.
To offer some insight into what it is to experience Athetoid Dyskinetic Cerebral Palsy and the associated movement disorders, consider an event that we’ve all experienced at some point in the twilight stages of sleep; just as we’re dozing off, our body twitches. Now imagine some extremity of your body, or your entire body, doing that when you’re awake, and not just once, but repetitively and there was nothing you could do to stop it!
- Quadriplegia – Affects all four limbs and the torso
- Triplegia – Confined to three limbs ( Triplegia )
- Hemiplegia – Affects only one side of the body
- Diplegia – Affects the lower extremeties and not the upper
Dyskinetic Cerebral Palsy (fluctuating tone), which also includes athetoid, choreoathetoid and dystonic cerebral palsies, is a neurological disorder resulting in a variety of movement disorders that include:
- Involuntary writhing movements
- Frequent, abrupt, jerky and involuntary gross motor movements
- Possible head and torso involvement
Associated Movement Disorders are Known as:
- Hyperkinetic (excessive)
- Bradykinetic (reduced) activity
- Spasticity refers to the inability of a muscle to relax
- Athetosis refers to an inability to control the movement of a muscle
Children with athetoid cerebral palsy have trouble holding themselves in an upright, steady position for sitting or walking, and often show lots of movements of their face, arms and upper body that they don’t mean to make (random, involuntary movements). These movements are usually big.
For some children with athetoid cerebral palsy, it takes a considerable amount of work and concentration to get their hand to a certain spot (like to scratch their nose or reach for a cup). Individuals with this disorder may appear to be in constant motion and often have speech difficulties. Because of their mixed tone and trouble keeping a position, they may not be able to hold onto things (like a toothbrush, fork or pencil).
Involuntary Movements Classified As:
The effects of various cerebral injuries depend on the location and severity of the damage. Effects can range from complete loss of a function to compromised and diminished function. It is possible to determine the location of a cerebral injury by determining what functions and abilities are absent or diminished. Cerebral insult or injury to the parasympathetic or sympathetic portions of the midbrain can result in athetoid cerebral palsy since the mid brain plays a role in facilitating motor function and muscle tone.
This type of cerebral palsy was once common as a result of blood type incompatibility, but is now rarely seen. Athetoid cerebral palsy affects about 10% of children diagnosed with a form of Cerebral Palsy.
Many physicians are reluctant to make a diagnosis of Cerebral Palsy until a child is 18 to 24 months old. Many of the normal developmental milestones are based on motor functions such as:
- Reaching for toys (3-4 months)
- Sitting (6-7 months)
- Walking (10-14 months)
Some of the most pronounced movement disorders associated with athetoid cerebral palsy may not be evident until a child is expected to achieve certain developmental milestones. Parents are often the first to suspect that their baby’s motor skills are not developing normally and should contact their physician with any concerns, since they can help distinguish normal variation in development from a developmental disorder. Most children with cerebral palsy are diagnosed by 3 years of age. Early assessment and intervention are vital in helping a child with this disorder, to meet developmental milestones.
Many children may be only mildly inconvenienced with the related movement disorders and neuromuscular involvement, while others may face years of therapies, medications and possibly surgeries to manage and reduce the consequences of athetoid cerebral palsy.
Some may be at increased risk for muscular skeletal complications such as contractures and scoliosis due to poor torso control in addition to compromised oral motor function resulting in speech and feeding challenges.
Many individuals with cerebral palsy have no additional medical disorder. However, depending on the nature of the cerebral injury, children with athetoid cerebral palsy may or may not exhibit developmental delays or learning disabilities. Many may have learning challenges due to the distraction the neuromuscular disorder causes, and the impact it would have on a child’s ability to focus and retain information. Some may additionally experience seizures, impaired intellectual development, oral motor skill dysfunction, vision and hearing impairment. Coping with these disabilities may be even more of a challenge than coping with the motor impairments of athetoid cerebral palsy.
Medications can be prescribed to administer orally or via a feeding tube that can help reduce spasticity and the severity of the related movement disorders. They include: baclofen, diazepam or others your physician may consider beneficial. Additionally, therapy, supportive treatments and surgery may be necessary and can help many individuals improve their motor skills and ability to function and communicate with the world. Early childhood intervention programs are vital in identifying, addressing and managing the developmental and neuromuscular issues that some children may experience with this disorder. Untreated, a child with moderate to severe athetoid cerebral palsy can suffer severe developmental delays and be at risk for crippling neuromuscular conditions.
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