Spastic cerebral palsy is a disorder that involves muscle stiffness. Symptoms and signs may include difficulty walking, trouble manipulating objects, and vision, hearing, or speech challenges.

“Cerebral palsy” is an umbrella term for a group of movement disorders caused by brain damage during infancy or early childhood. Cerebral palsy often leads to permanent disability that affects body movement and muscle coordination.

According to the Centers for Disease Control and Prevention (CDC), spastic cerebral palsy is the most common type of cerebral palsy, affecting about 80% of children with the disorder.

“Spastic” means stiff muscles. “Cerebral” means related to the brain. “Palsy” means weakness or difficulties using your muscles.

People living with spastic cerebral palsy have increased muscle tone that causes stiff muscles, which leads to atypical or jerky movements.

Signs and symptoms vary depending on which parts of the body are affected.

Spastic diplegia involves muscle stiffness mainly in the legs. Symptoms or signs may include:

  • walking difficulties
  • atypical posture or an inability to stand or sit upright
  • tightness in the knees that causes a change in standing posture
  • tightness in the legs that causes them to move in a scissor-like motion
  • hyperactive reflexes in the legs

Spastic hemiplegia involves muscle stiffness in one side of the body, usually affecting the arms more than the legs. Symptoms or signs may include:

  • tasks using the arms or hands may be difficult, such as:
    • getting dressed
    • writing
    • manipulating objects
  • a shorter and thinner arm and leg on one side of the body
  • walking later in life than usual or on tiptoe
  • scoliosis (curved spine)
  • delayed speech

Spastic quadriplegia is the most severe form of cerebral palsy and involves muscle stiffness that affects all four limbs as well as the trunk and face. Symptoms may include:

  • extreme stiffness in the limbs
  • inability to walk
  • slurred speech or slow oral movements
  • difficulty eating or drinking

Spastic quadriplegia is also linked to moderate to severe intellectual disability, seizures, and difficulties with vision or hearing.

Some medical professionals also use the terms “bilateral” and “unilateral” to describe spastic cerebral palsy. Bilateral means stiffness affects both sides of the body. Unilateral means stiffness affects only one side of the body.

Vs. ataxic cerebral palsy

Ataxic cerebral palsy is a rarer type of cerebral palsy that affects 5–10% of children with the disorder.

Children who have ataxic cerebral palsy may experience difficulties with balance, coordination, and depth perception. Signs and symptoms may include:

  • atypical movements like wobbly or shaky motions or gestures
  • unbalanced walking with a wide gait
  • limited coordination
  • slow and imprecise movements
  • difficulty managing movements with the hands or arms, such as when reaching for objects

While spastic cerebral palsy may involve some similar symptoms, the movement difficulties are caused by muscle and joint stiffness rather than challenges with balance and coordination.

Cerebral palsy is caused by brain damage or abnormal brain development during infancy or early childhood.

Possible causes may include:

  • bleeding in a baby’s brain, commonly caused by fetal stroke
  • severe lack of oxygen in a baby’s brain
  • head injury
  • mutations in the genes that influence brain development

In many cases, the exact cause of cerebral palsy is unclear.

Certain medical conditions and events during pregnancy or delivery can increase the chance of a baby being born with cerebral palsy. These conditions and events may include:

  • low birth weight
  • premature birth
  • multiple births at once, such as twins and triplets
  • infections and fever during pregnancy
  • exposure to toxic substances
  • female parents with chronic health conditions, especially autoimmune diseases

To diagnose cerebral palsy, healthcare professionals may start by performing a physical exam of your child and asking about your child’s medical history.

They’ll look for any signs and symptoms of a permanent, nonprogressive disorder of motor function (movement). They may also order tests to assess your child’s motor skills.

During regular visits, healthcare professionals may track and check your child’s:

  • development
  • growth
  • muscle tone
  • motor skills
  • posture
  • coordination

The healthcare team may also order additional tests to look for signs of cerebral palsy or rule out other conditions. These tests can include:

If a medical professional makes a diagnosis of cerebral palsy, they’ll further classify the type of cerebral palsy based on the nature of the movement disorder:

  • spastic cerebral palsy if stiff muscles are involved
  • dyskinetic cerebral palsy if uncontrollable movements are observed
  • ataxic cerebral palsy if atypical coordination is evident
  • mixed types, depending on the signs

Most children get their cerebral palsy diagnosed by 2 years of age, but children with mild symptoms may not have their condition diagnosed until 4 or 5 years.

Treatment for cerebral palsy depends on the symptoms a child is experiencing. Goals may include:

  • increased mobility
  • reduced pain
  • decreased muscle spasms
  • improved range of motion

Treatment options can include:

  • medications, such as muscle relaxants and pain relievers
  • physical therapy
  • occupational therapy
  • recreation therapy
  • speech and language therapy
  • dietary supplements
  • mental health counseling
  • surgery
  • assistive devices
  • management of related conditions, such as:
    • pressure ulcers
    • osteoporosis
    • incontinence

A team of specialists can help manage different kinds of care and develop a treatment plan tailored to your child’s symptoms.

Specialists may include:

  • neurologists
  • developmental pediatricians
  • surgical specialists
  • ophthalmologists
  • otologists
  • others

Treatment for spasticity

Children who have spastic cerebral palsy will need targeted treatment for spasticity, as best described in an article from 2014. “Spasticity” refers to the increased muscle tone that results in stiff muscles.

The aim of treatment for spasticity is to prevent and correct bone and joint structural changes, manage pain, and maintain function.

Primary care doctors typically refer children with spastic cerebral palsy to a surgical specialist, who can help select appropriate treatments.

Treatment for spasticity may include:

  • nerve blocks
  • soft tissue lengthening
  • tendon transfers
  • joint stabilization
  • onabotulinumtoxinA (Botox)
  • systemic antispasticity medications, such as baclofen (Gablofen, Lioresal) and diazepam (Diastat AcuDial, Diazepam)
  • selective dorsal rhizotomy

The outlook for children with cerebral palsy depends on the severity of the condition and related medical conditions.

As diagnosis and treatment for cerebral palsy have improved, children who have the disorder are living longer and more independent lives.

Most children with cerebral palsy have a near-typical life expectancy. Nearly all children with the disorder, according to a 2016 article, survive well into adulthood.

With adequate care and support, children with all types of cerebral palsy can live active and fulfilling lives.

Spastic cerebral palsy is a movement disorder that causes muscle stiffness and atypical movements.

Children with the disorder may experience varying levels of disability that can affect the lower body, upper body, one side of the body, or the whole body.

Treatment and ongoing support can help children improve mobility, reduce pain, and live an active, fulfilling life.