Spastic diplegia is a specific type of cerebral palsy that affects the muscle tone, muscle control and muscle coordination of those affected. This condition affects each person differently, and it is often difficult to treat. Spastic diplegia is a rare condition and there is no known cure.
Definition & Facts
Cerebral palsy is a term used to describe a vast array of neurological disorders. The symptoms associated with cerebral palsy occur during early childhood. The effects of these conditions are permanent. Cerebral palsy is characterized by damage to the parts of the brain that control movement and coordination. Spastic diplegia is a form of cerebral palsy. It is chronic.
Symptoms & Complaints
- Walking on toes
- Scissor gait – a type of gait abnormality
- Delay in rolling over in infancy
- Difficulty standing
- Exaggerated reflexes
- Rigid muscle tone
- Lack of fine motor skills
- Weakness on one side of the body (hemiparesis)
- Loss of muscle coordination
- Floppy tone (hypotonia)
People who suffer from cerebral palsy may also have secondary health issues. High blood pressure, urinary incontinence, fecal incontinence, scoliosis, bladder problems, hip dislocations, and bone fractures are more common in those with this condition.
People with neurological conditions of this nature may also be at an increased risk of depression, chronic pain, post-impairment syndrome, fatigue, muscle weakness, and premature aging. Cerebral palsy patients are also more likely to develop degenerative arthritis and osteoarthritis. This is due to the abnormalities in the body that cause joint compression and reduced strength.
Spastic diplegia occurs when the brain forms abnormally or is damaged during birth or shortly thereafter. Many cases of spastic diplegia are caused by unknown factors, in which case the disorder is said to be (idiopathic). There are a few factors doctors feel contribute to this disorder:
- Infection in the mother while pregnant
- Maternal fevers
- Brain injury during birth or shortly after
- Lack of blood flow to the brain during birth (brain ischemia)
- Severely restricted oxygen flow to the brain (cerebral hypoxia)
Experts have found that children who have siblings with the condition are more likely to develop it themselves. The following is a list of other factors that may contribute to cerebral palsy:
- Multiple birth pregnancy
- Premature birth
- Low birth weight
- Mothers with thyroid problems
- Jaundice in newborns
- Difficult labor and complicated delivery
- Breech birth
- Presence of inherited disorders
Diagnosis & Tests
Doctors base the diagnosis of cerebral palsy on the types of symptoms exhibited in each patient. The doctor will gather as much information from the patient's mother as possible regarding labor and delivery. This an important part of the diagnostic process because many people who have these disorders suffered an injury to the brain during birth.
Doctors may also use a variety of diagnostic tests such as blood tests, computed tomography (CT) scans, magnetic resonance imaging (MRI)s, electromyography, and electroencephalogram (EEG's). These tests may rule out other conditions which helps confirm the diagnosis of spastic diplegia.
Treatment & Therapy
There is no cure for spastic diplegia, but doctors form a treatment plan based on the types of symptoms present and the severity of illness. While there is not a set treatment plan for this condition, many children attend physical therapy. This type of treatment helps stretch rigid muscles and improve flexibility. A physical therapist can also fit children with special braces or other mobility aids if necessary.
Children who have speech problems may require speech therapy, as well. These therapists teach children how to speak more clearly if possible. They also help children learn to communicate non-verbally if they cannot speak well. In addition, occupational therapists may help improve functional mobility. These therapists specialize in teaching patients how to perform activities of daily living.
Doctors may prescribe medication to help lessen muscle rigidity. Those who have severe symptoms may require orthopedic surgery to improve gait or lessen pain. Children who have spastic diplegia may require assistive devices such as walkers or wheelchairs to help them be mobile at home and school. This is an important part of helping those with cerebral palsy be independent.
The prognosis for those with spastic diplegia depends on the severity of the condition. Those with less severe forms of the disorder may be able to function fully on their own as they age. Others who are severely affected may require assistance throughout their lives.
Prevention & Prophylaxis
Researchers at the National Institute of Neurological Disorders and Stroke are working on ways to determine how environmental factors affect the development of these neurological conditions. The center also tests new drugs that can reduce muscle rigidity and other symptoms associated with spastic diplegia. The types of studies conducted at this research facility are aimed at understanding why the brain is damaged at a certain point in fetal development and how it can be avoided.