Most children who suffer from cerebral palsy suffer from a single form of the condition, such as spastic, ataxic, or athetoid cerebral palsy. However, a meaningful percentage of cases involve children who suffer from multiple forms of cerebral palsy at the same time. This is often known as mixed cerebral palsy. It tends to arise when a child suffers harm to multiple areas of the brain that affect their motor functions. Some children may exhibit symptoms mostly in their limbs, while others may exhibit symptoms throughout the body.
The main areas of the brain that control movement include:
Motor cortex: This part of the brain issues commands to other parts of the brain that control movement. Children who suffer damage to the motor cortex may suffer from spastic cerebral palsy in their muscles, joints, and tendons.
Pyramidal tracts: This is one of the areas to which the motor cortex sends commands. If the pyramidal tracts are damaged, they may not be able to effectively receive signals from the motor cortex. Thus, a child may develop spastic cerebral palsy, as shown by problems with their movement.
Cerebellum: While damage to the motor cortex and the pyramidal tracts usually results in spastic cerebral palsy, harm to the cerebellum usually leads to athetoid or ataxic cerebral palsy. The cerebellum controls complex motor functions, such as balance and coordination, and can affect communication.
Basal ganglia: Children who sustain harm to the basal ganglia typically suffer from athetoid cerebral palsy, which causes problems with muscle tone and muscle control. The basal ganglia receive commands from the motor cortex and transmit them to the brainstem.
A baby who lacks an adequate flow of oxygen to the brain may suffer damage to any of these areas. In other cases, an undiagnosed or untreated infection may cause brain damage. Other sources of brain damage include hemorrhages and stroke suffered by a fetus or infant.
Symptoms of Mixed Cerebral Palsy
Children who have mixed cerebral palsy will display the symptoms associated with each type of cerebral palsy from which they suffer. Failing to meet movement-related milestones after birth, such as sitting up, crawling, or walking, may indicate at least one type of cerebral palsy. Problems with involuntary, stiff, or excessive movements or a lack of balance or coordination also should be red flags. Children may suffer from tremors or issues with their reflexes.
The main forms of cerebral palsy are spastic, athetoid, ataxic, and hypotonic cerebral palsy. Spastic cerebral palsy primarily involves stiff, jerky movements caused by excessive muscle tone. Athetoid cerebral palsy primarily involves fluctuations between overly stiff and overly loose muscles. Ataxic cerebral palsy primarily involves disruptions to balance and coordination. Hypotonic cerebral palsy afflicts children who suffer from overly floppy muscles.
Spastic Cerebral Palsy Dominates
The most common combinations of cerebral palsy types are spastic cerebral palsy with athetoid cerebral palsy, or spastic cerebral palsy with ataxic cerebral palsy.
Treatment for Mixed Cerebral Palsy
Since mixed cerebral palsy is a multifaceted condition, physicians may need to develop an equally multifaceted treatment plan for a child. While no type of cerebral palsy can be cured, treatment often can help a child live a relatively fulfilling adult life. Various forms of therapy may improve symptoms. These include physical therapy, which may involve exercises to improve the strength and flexibility of muscle groups. Meanwhile, occupational therapy helps children gain greater independence by improving their ability to perform everyday tasks. Occupational therapy may focus on controlling and coordinating movements. Finally, speech therapy may help children who struggle with speaking or eating. These techniques can bolster areas such as language development, jaw mobility, and breathing.
Sometimes a doctor will complement therapy with assistive devices or medications. Assistive devices may involve braces for limbs in relatively mild to moderate cases, or wheelchairs in more severe cases. Some forms of medication prescribed to children with mixed cerebral palsy treat their movement issues directly. Other types of drugs can address secondary conditions resulting from brain damage.
Will Surgery Help?
While surgery is not the right solution for every situation, it may help children suffering from spastic cerebral palsy and sometimes children with athetoid cerebral palsy. The long-term benefits of surgery can include freer movement and pain relief.
Legal Claims Based on Mixed Cerebral Palsy
While not every case of mixed cerebral palsy can be prevented, medical malpractice is a common cause of these conditions. Families burdened with the massive costs of caring for a child with mixed cerebral palsy should consider legal action. They can recover compensation for past, present, and future costs related to therapies, medications, assistive devices, surgeries, and other treatments required for their child. A child also may be able to recover compensation for pain and suffering caused by this condition.
To establish liability for mixed cerebral palsy, a family will need to show that the defendant health care provider failed to meet a professional standard of care. This typically requires introducing expert testimony to explain what the defendant did wrong and how this caused mixed cerebral palsy. Birth injury lawsuits are complex and challenging. Doctors and hospitals tend to fight these cases vigorously, so parents likely should retain their own legal counsel before bringing a claim. Most birth injury attorneys offer free consultations and collect their fees only as a percentage of a settlement or verdict for a client.