What Is Mixed Cerebral Palsy?
Many cerebral palsy patients do not have the symptoms of a single type of cerebral palsy. These patients have what specialists refer to as mixed cerebral palsy. This type manifests itself through a range of symptoms common to spastic, athetoid, and ataxic cerebral palsy.
Mixed Cerebral Palsy Overview
Mixed cerebral palsy is a form of cerebral palsy which shares commonalities with three other recognized types of cerebral palsy. Mixed Cerebral Palsy accounts for approximately 10% of all people with cerebral palsy. Mixed C.P. is the combination of at least two forms of cerebral palsy. Mixed C.P. is is caused from injuries to the brain.
Physicians classify a person whose symptoms fall into two or more of these categories as having mixed cerebral palsy. A blend of spastic and athetoid cerebral palsy types is the most common type of mixed cerebral palsy. A mix of ataxic and athetoid cerebral palsy types is the least common variety.
Since mixed cerebral palsy manifests a condition that incorporates elements of other types of cerebral palsy, symptoms can vary from person to person with this diagnosis. However, the symptoms experienced by people with mixed cerebral palsy are common to other types of cerebral palsy.
Cerebral Palsy Care, an initiative of the BRIGHT Foundation, reports that a type of mixed cerebral palsy called spastic/athetoid cerebral — regarded for its similarities to spastic and athetoid types of cerebral palsy — is the most common.
The stiff muscles inhibiting movement common to spastic cerebral palsy is a dominant symptom for people with this condition, although often involuntary movements associated with athetoid cerebral palsy will occur more often as a patient grows. These involuntary movements might include repetitive twisting movements, slow writhing movements, and irregular and unpredictable jerking movements.
Difficulty with motor skills, speaking, and swallowing are also common among people with mixed cerebral palsy. Symptoms often become more pronounced when people become agitated or excited, and ease when they are calm, such as during sleep.
What Causes Mixed Cerebral Palsy?
The main cause of Mixed Cerebral Palsy is brain damage or anomalous brain development. The severity of cerebral palsy and disability can be determined through various factors:
- Location of brain damage
- Extent of brain damage
- Extent of abnormality
- Maternal infections
- Fetal infections
Signs, Symptoms, and Conditions
People with mixed cerebral palsy may have a number of symptoms commonly associated with other types of cerebral palsy. These symptoms may include the following:
- Muscle tone that may be stiffer or looser than normal, causing impaired or involuntary movements
- Difficulty performing fine motor skills
- Tremors or shaking
- Difficulty balancing
- Visual or hearing impairment
- Learning difficulties
- Scoliosis, hip dislocation, or other skeletal abnormalities
- Difficulty speaking or swallowing, sometimes causing drooling
- Incontinence or constipation
Stiff muscles and involuntary movements are the most common symptoms of mixed cerebral palsy. Severity of symptoms of mixed cerebral palsy is dependent on severity of a person’s brain injuries. While the condition does not progress over time, symptoms may become more pronounced with age.
Treatment for Mixed Cerebral Palsy
Although no cure exists for mixed cerebral palsy, treatment options aim to control the symptoms and improve quality of life. A number of treatments may be beneficial to someone with mixed cerebral palsy.
The National Institute of Neurological Disorders and Stroke notes that many patients begin physical therapy within their first few years of life. This type of therapy aims to improve a patient’s movement, muscle strength, motor skills, and balance. While the therapy will vary depending on the patient’s specific problems, therapy activities will usually include strength training and flexibility exercises. Physical therapy may often work together with mobility aids, such as braces and splints.
Speech therapy can help people with mixed cerebral palsy communicate better with others. Speech therapist may help a person learn to speak or speak more clearly. Alternatively, a speech therapist may teach sign language and other means of communication, such as using a computer with a voice synthesizer.
Occupational therapy can also be very important to people with mixed cerebral palsy. This type of treatment teaches how to be more independent through the mastery of common tasks, such as using the toilet and eating a meal.
Medications can help ease the pain and discomfort for people with mixed cerebral palsy. Oral medications, such as diazepam and baclofen, are usually the first choice for treating mild stiffness in the muscles or widespread spasticity. Baclofen may also be delivered using an implantable pump. Botulinum toxin injections can also relax overactive muscles.
People with skeletal abnormalities may correct them with orthopedic surgery. Orthopedic surgeries might lengthen muscles which are too short or correct a spine that’s deformed through scoliosis. While not ideal for all cases, selective dorsal rhizotomy is another option. Through these procedures, specialist surgeons cut nerve endings in the low spinal column to improve movement and reduce muscle stiffness.
Therapeutic electrical stimulation is another treatment option. This treatment delivers electrical stimulation to the body while the patient sleeps. The treatment increases blood flow to weak muscles, which helps them grow and repair themselves. Physical therapy usually complements a three- to six-month course of therapeutic electrical stimulation.
Through treatment options like these, the Cerebral Palsy Association in Alberta observes that people with cerebral palsy, including mixed cerebral palsy, can attend school, gain employment, marry, raise families, and enjoy all the opportunities of independent living.
In addition to this specific information on this type of CP, you may find our pages about other types of cerebral palsy beneficial to improving your understanding of this condition.
Sources Used in This Article
- Cerebral Palsy Tasmania
- Cerebral Palsy Care
- Cerebral Palsy Alliance
- Center for Cerebral Palsy at UCLA
- University of Virginia School of Medicine – Types of Cerebral Palsy
- Pathophysiology for the Health Professions
- NHS – Cerebral Palsy: Symptoms
- West Sussex County Council – Cerebral Palsy Fact Sheet
- Cerebral Palsy: Hope Through Research
- Johns Hopkins – Cerebral Palsy