Cerebral Palsy Types - Toronto Lawyers
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There are three main types of cerebral palsy being named spastic, athetoid and ataxic together with a fourth combination type named mixed cerebral palsy:-
Ataxic Cerebral Palsy
Ataxic cerebral palsy is one of the main classifications of this condition, three of which may exist in isolated types known as the spastic, ataxic, or athetoid or there may be elements of all of them co-existing in a mixed category.
Ataxic cerebral palsy which affects less than 10% of victims is diagnosed by clinical observation and is characterized by low muscle tone and poor co-ordination causing limbs to appear floppy and loose. This condition stems from damage to the spinal cord and cerebellum which affects the entire body and often causes balance problems and unsteady movement. This condition usually results from naturally occurring phenomena often in the form of a birth defect however a significant proportion of cases, probably more than 10% is the result of medical malpractice occurring immediately before, during or shortly after birth. There is no specific treatment for this condition although the disability may be reduced by physical therapy, exercises and the use of equipment such as a walking cane, leg braces and shoe splints.
Children and infants with ataxic cerebral palsy look very unsteady and shaky, with tremors that are similar to those associated with the elderly and infirm. Affected people often have poor coordination and walk unsteadily with a wide based gait, placing their feet unusually far apart to attempt to secure their own stability. These uncontrolled movements are especially noticeable during actions requiring acute motor skills including writing or turning the page of a book or cutting with scissors.
Individuals suffering from ataxic cerebral palsy often experience difficulty reaching for objects because of affected depth perception. They may also experience intention tremors which begin when a voluntary movement, such as reaching for an object, causes a trembling that affects the body part being used and which worsens as the individual gets nearer to the desired object. Victims may also suffer from dysarthria which is characterized by slurred speech and sometimes by explosive variations in voice intensity despite a regular vocal rhythm.
The term 'ataxia' arises from a Greek word which means 'lack of order' and can refer to a more general condition which can manifest itself in the form of sensory, vestibular or cerebellar ataxia. All three types can have overlapping causes and can all exist side by side or they may exist in isolation. Ataxic cerebral palsy can be caused by hereditary factors in addition to birth defects or medical malpractice. The two most prevalent types of the hereditary condition are Friedreich's (recessive) and Marie's (dominant). The cerebellum and spinal cord are affected in this form of the condition which is passed to the next generation via a defective gene. Individuals with no known family history can develop a spontaneous occurrence called sporadic ataxia.
Athetoid Cerebral Palsy
Athetoid cerebral palsy affects less than 20% of people who suffer from this condition and is characterized by muscle tone that is mixed in that it may be too high or too low resulting in muscles that intermittently change from floppy to tense. It often affects the hands, feet, arms or legs and can occur mixed with the spastic form or the ataxic form or there may be elements of all of them co-existing in a mixed category. This condition is most often a naturally occurring phenomena however about 10% of case are the result of medical malpractice occurring shortly before, during or immediately after birth.
Athetoid cerebral palsy which is characterized by offset muscle tone leads to difficulty with control and coordination of movement and may be most obvious when a child attempts an upright steady position for walking. Uncontrolled movements will often increase during stressful times and will usually disappear while sleeping. This condition is caused by damage to the cerebellum or basal ganglia areas of the brain which are responsible for processing the signals that enable smooth, coordinated movements as well as maintaining body posture. Damage may cause involuntary, purposeless movements, especially in the face, arms and trunk which interfere with speaking, feeding, reaching, grasping and other skills requiring coordinated movements. The muscles in the face or tongue are sometimes affected resulting in involuntary grimacing and tongue thrusting which may lead to swallowing problems, drooling and slurred speech which is a condition known as dysarthria.
Athetoid cerebral palsy may occur as a result of a large increase in the amount of bilirubin in the blood of the newborn infant. An increase in the concentration of this body chemical results in jaundice and may cause injury to the brain which is known as kernicterus. There are several reasons for an increase in bilirubin concentrations in the newborn infant including genetic factors, the effect of certain medications, infections and Rh factor blood incompatibility between the mother and the infant.
Spastic Cerebral Palsy
The most commonly occurring type of cerebral palsy which affects over half of all sufferers is spastic cerebral palsy. In about 10% of cases it occurs as a mixed form most often associated with athetoid movements and occasionally it occurs mixed with the ataxic form of the condition however all three types are rarely present together. The word spastic refers to muscle tone being too high or tight which causes stiff and jerky movements.
Children affected by spastic cerebral palsy usually have difficulty moving from one position to another and often cannot easily hold or release objects; however these rigid movements can often be controlled drugs, therapy and equipment. If both legs are affected it is called spastic diplegia and walking may be difficult because tight muscles in the hips and legs cause the legs to turn inward and cross at the knees which causes a characteristic walking rhythm known as the scissors gait.
Mixed Cerebral Palsy
This condition which results from damage to the brain often causes difficulties that can affect all or some of the limbs. Mixed cerebral palsy occurs when two or more of the primary types are present in the same person and occurs in about 10 percent of patients. Sufferers usually have both the tight muscle tone of the spastic form and the involuntary movements of the athetoid form. Whilst most cases of this condition are naturally occurring phenomena known as a birth defect, probably about 10% of cases are due to actionable medical malpractice whereby very substantial compensation can be claimed from a negligent healthcare professional.
The mixed variant is caused by injury to both the pyramidal and extra pyramidal areas of the brain. Usually the spasticity is the more obvious first symptom, with the involuntary athetoid movements increasing when the child is between nine months and three years old making the presence of mixed cerebral palsy more obvious. The most common combination is athetoid/spastic. The least common is athetoid/ataxic. Any combination of types can occur and it is possible to have a mixture of spastic, athetoid and ataxic.
Toronto Cerebral Palsy Lawyers
If you believe that your child's condition is as a result of medical malpractice and you would like advice from a Toronto cerebral palsy lawyer just call the helpline or complete the contact form or email our Toronto offices and a medical malpractice lawyer, based in Toronto will telephone to discuss your child's claim with no further obligation.
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