One page summary: Spastic cerebral palsy

In two sentences

Spastic cerebral palsy is the type where muscles are stiff and tight. It is the most common form of cerebral palsy. ¹

Spasticity means a muscle resists being stretched, and resists harder the faster you stretch it. The muscle itself is normal. The signal telling it to relax is not getting through.

The numbers, with their sources

• Share of cerebral palsy. Spastic cerebral palsy is the most common type, and NINDS describes it as accounting for the large majority of cases ¹
• The three patterns. Diplegia affects the legs more than the arms, hemiplegia affects one side, quadriplegia affects all four limbs and often the trunk and face ¹
• Common brain finding in diplegia. Injury to the white matter next to the ventricles, called periventricular leukomalacia, which is most common in babies born early ²
• Strongest therapy evidence for one-sided involvement. Constraint-induced movement therapy improves use of the affected arm in children with unilateral cerebral palsy ³
• Hip surveillance. Hips can move out of joint slowly and without pain, which is why X-ray surveillance on a schedule is part of standard orthopedic care ¹

What to do this week

1. Ask for the type, distribution and GMFCS level in writing.
2. Ask when hip surveillance starts and how often X-rays repeat.
3. Ask whether constraint-induced movement therapy is appropriate if one side is more affected.
4. Ask what the brace is for and what it should be doing, because "wear the brace" without a goal rarely lasts.
5. Refer to early intervention or the school district today.
6. Apply for your state's Medicaid waiver, because of the waiting lists.

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 physiatrist or neurologist

• Which muscles are the biggest problem right now, and what is the plan for each?
• Is botulinum toxin appropriate, and what will we pair it with?
• Is my child a candidate for selective dorsal rhizotomy, and what is the evidence in a child like mine?
• How do we track whether tightness is getting worse?

For the orthopedic surgeon

• What do the hip X-rays show, and what number are you watching?
• If we do nothing, what happens over the next two years?
• What is the goal of surgery: walking, comfort, sitting, or care?
• How many procedures, and what does recovery ask of us?

For the therapy team

• What is the one goal we are working on this quarter?
• How long should the brace be worn each day, and how do we know it fits?
• What should we do at home, and can you watch me do it once?

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 Spastic 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.