Cerebral palsy (CP) is a lifelong condition that affects a person’s movement, posture and muscle tone. It results from damage or abnormal development in the brain, often occurring before, during or shortly after birth. For families, understanding the different presentations of cerebral palsy is crucial for managing their child’s health and ensuring they receive the right support.

It is important to understand that the term "cerebral palsy" is an umbrella definition used to describe a number of related but distinct neurological disorders. Each type of cerebral palsy affects the body in unique ways, influencing muscle tone, movement and coordination. By identifying the specific type, medical professionals can tailor treatments to improve a child’s quality of life and help them achieve their potential.

In this blog post, we will explore the four main types of cerebral palsy - spastic, dyskinetic, ataxic and mixed - and highlight their characteristics and how they affect individuals. We will also discuss the importance of early diagnosis and the support available to children and families living with this condition.

What Is Cerebral Palsy?

Cerebral palsy is the most common motor disability in childhood, affecting approximately one in 400 children in the UK. It is caused by damage to or abnormal development of the brain, which interferes with the brain’s ability to control movement and muscle function. This brain injury often occurs during pregnancy, but it can also happen during childbirth or shortly after birth. Premature babies and those who experience complications at birth are at higher risk.

Children with cerebral palsy may experience a range of symptoms that vary in severity. These include:

• Abnormal muscle tone: Increased muscle tone (stiffness) or decreased muscle tone (floppiness).
• Movement disorders: Difficulty with coordination, balance, or motor skills, such as walking or reaching.
• Developmental delays: Challenges in reaching developmental milestones, such as crawling or sitting up.
• Involuntary movements: Uncontrolled movements that affect mobility and daily activities.
• Intellectual and developmental disabilities: In some cases, cognitive abilities may also be affected.

You can find out more about the symptoms of cerebral palsy from the NHS website.

Cerebral palsy is a highly individual condition, meaning its effects differ greatly from one person to another. For some, the condition is mild, affecting only a single limb, while others may experience severe forms that impact the whole body. Understanding the type of cerebral palsy your child develops is essential for tailoring treatment and support.

What Are The Four Main Cerebral Palsy Types?

Cerebral palsy is categorised into four main types based on how movement and muscle tone are affected. Each type corresponds to damage in specific areas of the brain, which leads to unique symptoms and challenges. Below, we explore the characteristics of each type and how they may affect a child’s ability to move and perform everyday tasks.

Spastic cerebral palsy

Spastic cerebral palsy is the most common form, accounting for around 70–80% of cases. This type is characterised by increased muscle tone, which causes stiffness and difficulty in moving affected muscles. The severity and specific areas affected depend on the type of spastic CP:

• Spastic diplegia: Primarily affects the legs, leading to stiff muscles and difficulty walking. Arm movements are usually less affected.
• Spastic hemiplegia: Impacts one side of the body, such as the left arm and leg. Children with spastic hemiplegia may have a noticeable difference in muscle tone between the two sides.
• Spastic quadriplegia: The most severe form of spastic CP, affecting all four limbs, the trunk, and the face. Children with spastic quadriplegia often have significant difficulties with movement and may also experience intellectual disabilities and seizures.

Dyskinetic cerebral palsy

Dyskinetic cerebral palsy, also known as athetoid cerebral palsy, is caused by damage to the basal ganglia, the part of the brain that helps control movement. This type is marked by involuntary movements, which may range from slow and writhing to jerky and abrupt. Children with dyskinetic cerebral palsy often have difficulty maintaining posture, controlling head movements, or performing precise tasks such as writing or eating.

When discussing dyskinetic cerebral palsy, you may see references to the following terms, all of which are related to this form of the condition:

• Dystonic cerebral palsy: This subtype is characterised by repetitive twisting movements, known as dystonia. Children with dystonic cerebral palsy often experience abnormal postures due to sustained muscle contractions, which can be painful and affect their ability to move freely.
• Hypotonic cerebral palsy: Hypotonia refers to reduced muscle tone, resulting in floppiness or weakness in the muscles. In children with hypotonic cerebral palsy, movements may lack strength and coordination, and they may find it difficult to sit, crawl, or walk independently.

Children with dyskinetic cerebral palsy often face fluctuating muscle tone, meaning their muscles may alternate between being too tight (hypertonic) and too loose (hypotonic). This variability complicates their ability to control movements consistently and perform daily tasks. They may also struggle with maintaining head control, sitting still, or performing precise movements, such as writing or eating.

Ataxic cerebral palsy

Ataxic cerebral palsy is a less common type of cerebral palsy, and results from damage to the cerebellum, the part of the brain that regulates balance and coordination. Children with this condition may experience:

• Poor balance: Difficulty walking steadily or maintaining posture.
• Shaky movements: Tremors when attempting precise tasks, such as drawing or picking up objects.
• Impaired motor skills: Challenges with tasks requiring fine motor function, such as buttoning clothes or using utensils.

This type can significantly affect a child’s ability to meet developmental milestones and perform daily activities.

Mixed cerebral palsy

Mixed cerebral palsy occurs when a child exhibits symptoms of more than one type of CP. The most common variation involves a combination of spastic and dyskinetic cerebral palsy, but other combinations can occur depending on the areas of the brain affected.

This type is less predictable than the others, as symptoms vary widely between individuals. A comprehensive assessment is essential to determine the best course of treatment and support for children with mixed cerebral palsy.

Each type of cerebral palsy affects children differently, but with the right interventions, therapies and support, it is possible to improve quality of life and promote independence.

How Is the Type of Cerebral Palsy Diagnosed?

Diagnosing cerebral palsy and determining its type often requires a thorough medical assessment by experienced medical professionals. Early diagnosis is essential, as it allows families to access tailored treatments and interventions that can significantly improve a child’s quality of life.

Diagnosing cerebral palsy involves the following steps:

• Monitoring developmental milestones: A child’s cerebral palsy is often suspected when they miss key developmental milestones, such as sitting up, crawling or walking. Parents may also notice unusual movement patterns, muscle stiffness, or floppiness.
• Clinical examination: A detailed physical examination is carried out to assess muscle tone, reflexes, posture, coordination and movement disorders. Medical professionals look for signs such as stiff muscles, involuntary movements or poor balance.
• Imaging tests: Advanced imaging techniques, such as magnetic resonance imaging (MRI), are used to identify abnormalities or damage in the developing brain. These scans provide critical information about the extent and location of the brain injury, which helps classify the type of cerebral palsy.
• Additional assessments: To evaluate how the condition impacts upon other areas of development, medical professionals may conduct tests on a child’s cognitive abilities, hearing, vision and speech. These assessments help create a comprehensive care plan tailored to the child’s needs.

Diagnosing cerebral palsy as early as possible allows families to begin physiotherapy, occupational therapy and other interventions during a child’s early developmental stages. Identifying the specific type - whether it be spastic, dyskinetic, ataxic or mixed cerebral palsy - helps medical teams and families make informed decisions about treatment strategies.

If you suspect your child may have cerebral palsy or are concerned about delays in their development, consult a medical professional without delay.

Living with Cerebral Palsy

Living with cerebral palsy presents unique challenges, but with the right support, children and adults can lead fulfilling lives. Understanding the type of cerebral palsy affecting a child is crucial for tailoring treatments, therapies and interventions to their specific needs.

While there is no cure for cerebral palsy, various treatments can help improve a child’s ability to manage symptoms and gain independence. These include:

• Physiotherapy: Focused on improving strength, flexibility and motor skills, physiotherapy is often one of the first interventions to be recommended. It helps children develop better control over affected muscles and improve movement.
• Occupational therapy: Enhances fine motor skills and helps children perform daily tasks such as dressing, eating and writing.
• Speech and language therapy: Supports children who struggle with communication or feeding due to muscle tone issues in the face or throat.
• Medications: Muscle relaxants or anti-spasticity drugs may be prescribed to reduce muscle stiffness or manage involuntary movements.
• Surgical interventions: In some cases, surgery may be required to correct joint deformities, lengthen muscles, or manage severe spasticity.

Caring for a child with cerebral palsy can be demanding, but there are resources available to assist families:

• Educational support: Many schools provide tailored learning plans and specialised equipment for children with intellectual and developmental disabilities.
• Financial assistance: Families may be eligible for disability benefits or grants to cover the cost of therapies, mobility aids, and other necessities.
• Support groups: Joining a community of parents and carers can provide emotional support, practical advice, and a sense of connection.
• Legal support: If medical negligence played a role in your child’s cerebral palsy, seeking legal advice can provide clarity and access to financial compensation. This can secure funds for long-term care, therapies, and other vital resources to support your child’s development.

For young children, early intervention is key to improving outcomes. By addressing motor skills, muscle tone and developmental milestones at an early age, children have the best chance of achieving their potential.