Spastic cerebral palsy
| Spastic cerebral palsy | |
|---|---|
 |
|
| Spastic hand(hemiplegia) | |
| Classification and external resources | |
| ICD-10 | G80 |
| ICD-9-CM | 343 |
Spastic cerebral palsy is the type of cerebral palsy wherein spasticity is the exclusive impairment present. It affects the cerebral cortex.
It is by far the most common type of overall cerebral palsy. Occurring in 90% of all cases according to the Society for Cerebral Palsy in Europe (SCPE); even if the 90% assertion is an exaggeration; however, more conservative scientific estimates still place the prevalence of spasticity-dominant cerebral palsy at anywhere from 70–80% of all cases, leaving cases dominated by ataxic cerebral palsy, dyskinetic cerebral palsy and athetoid cerebral palsy trailing at 20–30%.
People with the spastic/spasticity type of CP are hypertonic—i.e., they present with very stiff and tight muscle groups, far greater than typical humans—and have what is essentially a neuromuscular mobility impairment (rather than hypotonia or paralysis) which stems from an upper motor neuron lesion in the brain. The corticospinal tract or the motor cortex may be secondarily affected.
Spastic muscles are continuously contracting, and there is apparent weakness of their antagonists leading to abnormal positions of the joints on which they act. Abnormal postures are usually associated with the antigravity muscles, which are extensors in the leg and the flexors in the arm. Deformities of joints develop which may become fixed contractures with time. Changes in spasticity and postures may occur with excitement, fear or anxiety and pain which increase muscle tension.
Joint contractures are common in spastic cerebral palsy.
The upper motor neuron lesion in the brain impairs the ability of some nerve receptors in the spine to properly receive gamma amino butyric acid (GABA). That leads to hypertonia in the muscles signaled by those damaged nerves. The limbs and body areas in which hypertonia manifests can be any or even all of them, depending which specific nerve groupings within the spine are rendered unable to receive GABA. Thus, spastic CP is often designated by body topography.
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