Extrapyramidal Cerebral Palsy

Extrapyramidal Cerebral Palsy

Severe Cognitive and Motor Impairments

Often, the extrapyramidal form of cerebral palsy is preceded by hypoxic-ischemic brain injury or kernicterus. Medical records will often indicate that the newborn required respiratory support. Records may also indicate that hypoxic-ischemic encephalopathy (brain damage) may have been present at birth or caused during the perinatal period. This condition can lead to extremely serious consequences that lead to portions of the brain losing blood flow and oxygen. This can result in atrophy of the basal ganglia and necrosis--or death--of certain portions of the developing brain. While the child may survive, the damage may be substantial. For children with this type of CP, meaningful and voluntary movements are incredibly difficult to perform because muscles abnormally conflict with one another. Other signs of this condition involve extreme rigidity of muscles, defects in posture, and involuntary movements. Seizures, severe cognitive and motor impairments are quite common as well. Some muscles may be rigid while others are weak and prone to spasms making ambulation difficult. This syndrome is further divided into two subtypes: choreoathetotic CP and dystonic CP.

Choreoathetotic Cerebral Palsy

This is characterized by large, slow and involuntary movements, most often, in the limbs. Writhing and uncontrollable movement of the legs and arms may be common. Fingers and toes may also be placed in unpredictable positions and limbs may stretch and rotate involuntarily and unpredictably. Dystonia is often present; when a patient tries to move one part of their body, other parts move involuntarily. This may involve contraction of the facial muscles, twisting of the limbs and bending of the trunk. Chorea is also typical of this particular condition. This involves contractions of muscle groups in unpredictable, non-rhythmic, asymmetric, and involuntary ways. Ballismus, in extreme cases, may also be a sign of this type of CP. This is a movement disorder that causes the arms and legs to move about violently. A child with choreoathetotic CP may have substantial difficulties with speaking. Cognitive impairment and intellectual disability may also be quite severe.

Dystonic Cerebral Palsy

This form is quite rare. As in other forms of dystonia, the child's trunk muscles and the limbs are most affected. Head and neck movements may be slow and persistent. The child's head may lean in one direction consistently. Rapid and involuntary movements and repetitive retractions of the head may be common. Also, the torso may be curled into fixed abnormal positions. The above conditions may also lead to difficulties with sleeping, eating and even breathing.