Cerebral Palsy (CP)is caused by insult to the brain during the prenatal, perinatal or post-natal period. CP may cause global dysfunction but always causes motor dysfunction. CP causes an alteration in muscle tone, muscle stretch reflexes, primitive reflexes, postural reflexes, mental retardation, seizures, and vision/hearing deficits. There are several classifications of motor dysfunction associated with CP.
Spastic 70-80%
Quadriplegia 10-15% All 4 extremities involved
Diplegia 30-40% LE>UE involvement
Hemiplegia 20-30% One side of the body
Monoplegia rare one extremity
Dyskinetic 10-15%
Ataxic <5%
75% of CP clients exhibit upper motor neuron (UMN) lesions involvement including hyperreflexia, clonus, and spasticity. Hemiplegia is often seen in CP also. The CP client usually has weak hip flexors, ankle dorsiflexors, overactive posterior tibialis, hip hiking, and foot supination. This pattern is known as an extensor synergy. In the upper extremity, we see shoulder adduction, elbow flexion, forearm pronation, wrist flexion, and a clenched fist. This pattern is known as a flexor synergy.