One page summary: Mixed cerebral palsy

In two sentences

Mixed cerebral palsy means a child has more than one movement pattern at the same time. The most common combination is spasticity, meaning stiffness, together with dyskinesia, meaning movements the child does not intend. ¹

It happens when brain injury affects more than one system, which is common when the injury was widespread.

The numbers, with their sources

• What it means. Two or more movement patterns in the same child, most often spastic plus dyskinetic ¹
• Why it happens. Widespread brain injury affects both the pathways that carry movement commands and the deep structures that smooth movement out ²
• Why treatment is harder. Medicine that reduces stiffness can make unwanted movement more obvious, and medicine for dystonia can increase floppiness, so the plan is a balance rather than a fix ¹
• How it is classified. Guidance is to name the dominant pattern first and list the others, because the dominant pattern usually drives the treatment plan ¹
• What predicts function. The GMFCS level predicts everyday function better than the type or the mix does ³

What to do this week

1. Ask which pattern is dominant and what else is present, in writing.
2. Ask which component is causing the most functional trouble right now.
3. Ask what the treatment trade-off is for anything being proposed.
4. Set one goal for the next three months with the therapy team.
5. Ask for an AAC assessment.
6. Refer to early intervention or the school district.

Questions to take with you

Take these with you. Write the answers down in the moment, because you will not remember them later.

For the neurologist or physiatrist

• Which movement patterns does my child have, and which is dominant?
• If we reduce the stiffness, what happens to the other movements?
• Which one is limiting function most right now?
• What is the plan if the first medicine does not work?

For the surgeon, if surgery is proposed

• Does my child have a dystonic component, and how does that affect this operation?
• What specifically will be better afterward, and how will we measure it?
• What could get worse?

For the therapy team

• What is our one goal this quarter?
• How does seating change what my child can do with their hands?
• What do we do at home, and can you watch me try it?

You can also build a printable list with the question generator.

Where to read more

The full page on this condition covers how it happens, causes split into what happens even with perfect care and what is associated with gaps in care, signs by age, diagnosis, treatment, outlook, daily life and lifetime cost.

Read the full page on Mixed cerebral palsy

Related pages are listed at the bottom of it, including the events that can lead to this condition and the guides that cover therapy, school and money.