Brain-related Motor Disorders (Palsies)
Brain-related motor disorders (palsies) originate before birth, during birth, or very shortly after birth. They involve central tonus or coordination disorders. These are commonly referred to as childhood cerebral palsy (in adults, just cerebral palsy).
Childhood cerebral palsy (CCP) can be divided into three forms which may appear independently, or which can be mixed:
A) Spastic form of CCP: With this form of CCP, there is increased muscle tonus (hypertonia). Muscles are stiff. The mutual cooperation of muscles between tension and release is impaired.The basic symptoms of the spastic form of CCP include:
• Impaired motor ability,
• Stereotypical movement patterns,
• Stiff body position,
• Impaired balance,
• Difficulties with fine motor skills.
B) Athetosis: This form of CCP is typically associated with alternating muscle tonus. Muscle tonus is low if there is no movement, but with movement, the tonus is very high. Facial expressions are affected by involuntary grimaces. Further symptoms include:
• Difficulty controlling the position of the head,
• Problems eating,
• Problems with articulation,
• Limited control over balance.
With milder forms, walking is possible. At a later age, orthopedic defects almost always occur.
C) Ataxia: Manifests itself through decreased muscle tonus and the inability to make purposeful movements. Strong tremor appear when trying to make fine movements. Walk is unsteady. Further symptoms of this form of CCP involve:
• Deficiencies in movement coordination,
• Impaired balance,
• Limited fine motor skills,
• Dysartia manifests itself in speech.
Childhood cerebral palsy may affect:
1) All four limbs,
2) Lower limbs, or
3) A half of the body.
In the case of (1) quadriparesis/plegia, the entire body is affected (head, torso and all four limbs). The disorder affects fine motor skills, and frequent orthopedic disorders can be observed. Movement is possible mainly in a wheelchair.
In the case of (2) diparesis/plegia, the lower limbs are affected. Walking, or walking with the help of walking aids is possible. Orthopedic defects are also observed.In the case of (3) hemiparesis/plegia, half of the body is affected. Upper limbs are usually affected more severely than lower limbs. Very often, the affected person cannot move their fingers. Free walking is possible; however, balance is often impaired.
Palsies that originate later in the child’s life may most frequently be a result of injury, inflammation, or a degenerative disease of the central nervous system.