dystonic-cerebral-palsy-min

Cerebral Palsy is a non-progressive condition that causes a variety of movement-related disorders in your child. As a lifelong condition, early diagnosis and treatment is key to managing it and enabling the most functional life possible for your child. Often, there is confusion about what the subtypes of Cerebral Palsy look like and what warning signs to watch out for as your child grows. Here, we take a closer look at one of the more common variants of Cerebral Palsy, namely Dystonic Cerebral Palsy.

Understanding Dystonic Cerebral Palsy

Cerebral Palsy refers to a group of non-progressive neurological disorders that affect movement, muscle tone, coordination, and gait. It occurs due to damage to the brain on account of an injury or infection before, during, or shortly after birth. Cerebral Palsy affects gait, balance, gross and fine motor skills, and coordination, and may also lead to problems with vision and cognitive processing. A comprehensive treatment plan for Cerebral Palsy, can significantly reduce symptoms and help the patient function as independently as possible.

Dystonic Cerebral Palsy is a sub-variant of Dyskinetic Cerebral Palsy, and its chief symptom is involuntary muscle contractions that affect either the whole body or a single side. The involuntary movements tend to intensify when the patient attempts to control the movement, or when the patient is tired, anxious, or dehydrated. 

Symptoms of Dystonic Cerebral Palsy

Dystonic Cerebral Palsy is marked by uncontrollable movements and muscle contractions. These are often painful, which can make it uncomfortable to sit or lie down, and can interfere with sleep. The exact nature and severity of symptoms will vary from patient to patient, and in many cases may affect only one part of the body. There are several ways we can classify Dystonic Cerebral Palsy on this basis:

  • Focal dystonia affects just one side of the body. It can affect one leg and one arm along with the trunk of the body, or both legs and an arm. 
  • Hemidystonia affects an arm and the corresponding leg.
  • Cervical dystonia affects the head, neck, and shoulders and leads to abnormal twists and turns.
  • Generalized dystonia affects the entire body, often with an emphasis on the head and upper body. Children with this type of Dystonic CP experience significant problems with walking and voluntary movements.
  • Oromandibular dystonia affects the mouth, jaw, and tongue and leads to problems with eating and speaking.

For young children with Dystonic Cerebral Palsy, the symptoms may first appear in one hand or one foot before spreading elsewhere. In general, key Dystonic Cerebral Palsy symptoms that parents should watch out for include:

  • Painful movements
  • Movements that alternate between fast and slow
  • Involuntary movements that intensify if attempted to control
  • Speech difficulties 
  • Chewing and swallowing difficulties
  • Fatigue due to uncontrolled movements
  • Gait problems
  • Clumsiness
  • Drooling
  • Foot cramps
  • Uncontrollable blinking

Sometimes, the symptoms may only present during certain activities. For example, a child may have trouble walking, but may swim without difficulty.

Dystonic Cerebral Palsy causes

Dystonic Cerebral Palsy occurs due to damage to the basal ganglia. These are a group of subcortical nuclei in the brain that are in charge of motor function and learning. When the basal ganglia are damaged, messages from the brain to the muscles cannot be relayed properly, which leads to movement problems.

There are several factors that could damage the basal ganglia, including:

  • Problems with the placenta
  • Lack of oxygen during birth
  • Excessive force used during delivery
  • Premature birth
  • Low birth weight
  • Multiple births
  • Untreated jaundice at or soon after birth
  • Being shaken as a baby

In certain cases, genetics may also be responsible for the condition. There is no specific way to say exactly what caused a particular case of Dystonic Cerebral Palsy. An MRI or CT scan can indicate the location and extent of the brain damage, on the basis of which doctors can conjecture where the damage came from.

Treatment of Dystonic Cerebral Palsy

Tailored rehabilitation offers the best chance for long-term functionality and independence. Typically, Dystonic Cerebral Palsy treatment involves a team of healthcare specialists working concertedly to ease your child’s symptoms and help them participate in necessary activities. The components of a typical treatment plan include:

  • Physiotherapy: The physiotherapist can guide the child through special exercises. The focus is on improving strength, flexibility, and coordination, while also maintaining overall fitness.
  • Speech and Language Therapy: Speech therapists can teach a variety of exercises focused on the mouth and jaw to overcome muscle contractures and help the child speak and eat correctly. The speech therapist may also instruct the child in the use of communication devices or recommend the use of a feeding tube for proper nutrition.
  • Occupational Therapy: Occupational therapists train the child with Dystonic CP in performing activities of daily living (ADL) with as little assistance as possible. There are several exercises that improve control over fine motor skills such as eating, dressing, and bathing. 
  • Assistive devices: For children with more advanced symptoms, assistive devices can make getting around and daily functioning much easier. For instance, there are special types of cutlery designed for easy gripping. Walkers and wheelchairs can also be recommended for mobility.
  • Nutrition: Often, the doctor may recommend a tailored diet to ensure that the child is getting all the necessary calories and nutrients. This can be customized based on the child’s symptoms, such as gastrointestinal problems or speech disorders, while catering to the child’s tastes as far as possible. In particular, children with Dystonic Cerebral Palsy have high energy expenditure from all the contractures, which means nutrition is vital to avoid malnutrition.
  • Stem Cell Therapy: This is an important component of Cerebral Palsy rehabilitation and involves using the patient’s own cells to replace the damaged ones in the brain. This is a safe, painless procedure that can reverse the symptoms to a large extent. Research, in fact, demonstrates that Stem Cell Therapy can potentially cure Cerebral Palsy.

FAQs

  • Is dystonia the same as Cerebral Palsy?

Dystonia is a movement disorder that leads to uncontrollable muscle contractions and involuntary twisting movements. Dystonic Cerebral Palsy is a variant of CP in which the primary symptom is dystonia.

  • What are the 3 main types of Cerebral Palsy?

Cerebral Palsy can be classified into three categories depending on which body parts are affected. These are hemiplegia (one side of the body affected), diplegia (both legs affected), and quadriplegia (both arms and legs affected).

  • What is the difference between dystonia and spasticity

Dystonia and spasticity are both neurological conditions that impair movement. Spasticity is a velocity-dependent increase in tonic stretch reflexes that causes exaggerated tendon jerking. Dystonia, on the other hand, is an involuntary movement disorder that leads to abnormal postures and twisting, repetitive movements. 

  • What is the rarest type of Cerebral Palsy?/h3>

Ataxic Cerebral Palsy is the rarest subtype of Cerebral Palsy, accounting for only 2.4% of all cases.

  • What is the mildest form of Cerebral Palsy?

Often, Cerebral Palsy symptoms are mild enough that they are not noticed until the child is much older. Such patients can often get by on low-level support and can perform most activities without assistance.

  • Can Cerebral Palsy get worse with age?

Cerebral Palsy is a non-progressive condition, which means that the symptoms will not get worse with age. However, some symptoms can become more apparent as the child grows older.

  • What is the average lifespan of someone with Cerebral Palsy?

Cerebral Palsy itself does not affect the lifespan, and most children have survival rates similar to the average population. However, the more severe the condition, the greater the risk of associated conditions and low immunity, which tends to reduce life expectancy.

  • Is Cerebral Palsy painful?

Many children with Cerebral Palsy experience pain from muscle contractures and sudden involuntary movements. The degree of pain, however, differs from patient to patient.

  • What food is good for Cerebral Palsy?

A nutritious diet with whole foods is essential for patients with Cerebral Palsy. Eggs, nuts, avocados, whole grains, ginger, and greek yogurt are all good sources of nutrition.

  • What vitamins are good for Cerebral Palsy?

The best vitamins for Cerebral Palsy include Vitamin D, Vitamin C, omega-3 fatty acids, and Vitamin B12.

  • Is massage good for Cerebral Palsy?

Massage therapy twice a week can help to ease muscle spasticity and relieve pain in children with Cerebral Palsy. It also helps reduce anxiety and mental discomfort. 

  • What are acidic foods to avoid in cerebral palsy?

Children with Cerebral Palsy often have gastrointestinal issues that can be aggravated by spicy or acidic foods. Items to avoid or minimize include processed meats, processed cheeses, high-sodium foods, and certain grains.

Dystonic Cerebral Palsy can be challenging to live with, both for the child and for you as the parent. Be sure to talk to your child’s doctor about any concerns that you have and any changes you feel are necessary to the treatment plan. Above all, exercise love and patience with your child and encourage them in all their efforts. With regular rehabilitation and a supportive home environment, your child will learn to lead a happy, healthy life.

Dr Na'eem Sadiq is a respected stem cell specialist at Plexus, and a prominent neurologist in Bangalore. He studied neurology and clinical neurophysiology in London, and worked with some of the most prestigious medical institutions in England, and the Middle East. He completed his MBBS at Bellary Government Medical College, and a postgraduate degree in psychiatry from NIMHANS in Bangalore.

Dr Na'eem has perfected his knowledge and expertise in Continuing medical education (CME), and training in tissue culture, Stem Cell Therapy, and neurology. Dr Na'eem Sadiq possesses an undying passion to improve people’s lives. This led to the creation of Plexus, a neuro and Stem Cell Research centre in Bangalore in neurosurgery, and neurorehabilitation.