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Mixed cerebral palsy has symptoms of dyskinetic, ataxic and spastic CP appearing simultaneously, each to varying degrees, and both with and without symptoms of each. Mixed CP is the most difficult to treat as it is extremely heterogeneous and sometimes unpredictable in its symptoms and development over the lifespan.
Furthermore, deformities in cerebral palsy children are characteristically multilevel i.e. occurring at simultaneously at more than one joint. This adds to the complexity of orthopedic management of cerebral palsy children. Thus, multilevel orthopedic surgery is the mainstay of orthopedic management.
Spastic cerebral palsy is caused by malformation of or damage to the parts of the brain that control movement. [12] What exactly makes some children susceptible to such brain damage is often unknown but it is believed that cerebral palsy may be the result of causal pathways, or chains of events that cause or increase the likelihood of brain injury. [13]
The incidence of cerebral palsy has increased in the past 40 years. It has been estimated that, in the United States, cerebral palsy occurs in four out of every 1000 births. [11] Of those births, about 20–30% have spastic hemiplegia. Overall, spasticity is the more common type of cerebral palsy and non-spastic cerebral palsy is less common.
Characteristic symptoms are increased muscle tone (dystonia, such as clubfoot) and Parkinsonian features, typically absent in the morning or after rest but worsening during the day and with exertion. Children with dopamine-responsive dystonia are often misdiagnosed as having cerebral palsy. The disorder responds well to treatment with levodopa.
Ataxic cerebral palsy is known to decrease muscle tone. [3] The most common manifestation of ataxic cerebral palsy is intention (action) tremor, which is especially apparent when carrying out precise movements, such as tying shoe laces or writing with a pencil. This symptom gets progressively worse as the movement persists, causing the hand to ...
Based on symptoms, genetic testing [5] Differential diagnosis: Angelman syndrome, autism, cerebral palsy, childhood disintegrative disorder, various neurodegenerative disorders [6] Treatment: Special education, physiotherapy, braces [5] Medication: Anticonvulsants [5] Prognosis: Life expectancy for many is middle age. [5] Frequency: 1 in 8,500 ...
Dyskinetic cerebral palsy is a non-progressive, non-reversible disease. The current management is symptomatic, since there is no cure. The main goal is to improve daily activity, quality of life and autonomy of the children by creating a timed and targeted management.