Spastic Quadriplegia Cerebral Palsy | Cerebral Palsy Guidance

Spastic Quadriplegia, also referred to as spastic quad or spastic quad CP,is a form of cerebral palsy that means the loss of use of the whole body.Its the most severe of the three types of spastic cerebral palsy, marked by the inability to use thelegs, arms and body.

Spastic quadriplegia is generally caused by brain damage either before birth, during, or shortly after. There are many factors that can play into an infant developing brain damage, including fetal infections, maternal infections, exposure to toxins,or medical negligence.

During 26 to 34 weeks gestation, the white matter of an infants brain is greatly susceptible to damage. White matter sends signals fromthe brain to the rest of the body, and ifdamaged, it can lead to the entire body being affected.Lesions or holes in the white matter of the brain can lead to spastic quadriplegia.

Infants in utero canalso develop brain damage from fetal strokes, which can lead to brain bleeding. In some instances, fetal strokes are caused by placental blood clots and placenta previa. Weakly-formed blood vessels in the brain mayalsolead to fetal strokes.

Maternalhigh blood pressure during pregnancy leads to a heightenedrisk of fetal stroke. This is an unfortunate yet common issue during pregnancy, and its up to physicians to help monitor mothers throughout pregnancy, as well as diagnose and treat arising issuesas soon as possible.

Symptoms of spastic quad include:

Sincespastic quadriplegia can affects the childs entire body, theyare at risk of developing limb deformities. Spastic muscles continuously pulling can cause serious issues over time, especially if not treated properly.Around 1/4 ofpatients with CP develop scoliosis (a curvature of the spine). Those with spastic quadriplegia primarily develop it more than any other type of CP.

Another common issue is foot deformities. For instance, ankle equinus, a condition whereankle flexibility is limited, is a potential complication of spastic quad. Another complication associated with spastic quad CP is an issue known as foot drop or drop foot,makes it difficultto raise the front of the foot.

People with spastic quadriplegia may have great difficulty swallowing and this can lead to respiratory difficulties if food is aspirated. Because of the swallowing difficulties, proper nutrition is also a concern. In addition, this form of CP makes the person especially prone to bladder and bowel difficulties.

Spastic quadriplegia is generallydiagnosed duringinfancy, when doctors detect a significant delay in the babys development. Its one of the few types of cerebral palsy in which diagnosis happens before the child turns 1.

Treatment for spastic quadvaries with each case, depending upon the severity. In most cases, there are five types of traditionaltreatment options for children with spastic CP, which include: physical therapy, occupational therapy, speech therapy, medications, and in some instances, surgery.

Physical Therapy

The first linetreatment forchildren with any form of spastic cerebral palsy is almost alwaysphysical therapy. Physical therapists aim toprovide children the tools to be as independent as possible, viaflexibility exercises, stretching, andrange-of-motion (ROM) activities. Therapists use age-appropriate toys and games to make physicaltherapy as enjoyable as possible.

Occupational Therapy

The goal of occupationaltherapy is to help a child develop skills to perform daily activities and tasks in an independent matter, which ultimately helps them at home, school, and within their community. Since children with spastic quad have limited abilities to use their arms and legs, much of occupational therapy may focus on ways to strengthen their hands and fingers.

Speech Therapy

Speech therapy, as its name suggests, is a form of therapy to help improve speech and speech patterns. The goal of speech therapists is to help with oralarticulation and coordination.Some children with spastic quad are prone todrooling, and may have a hard time swallowing, which in turn affects their speech. Speech therapists teach various exercises thatincorporate assistive communication devices can help improve bothoraland cognitive abilities.

Children who participate in speech therapy participate in activities toclearly communicate their thoughts and ideas, socialize with loved onesand improve literacy. Speech therapy canalsohelp chewing, breathing and swallowing difficulties.=

Medications

A number of medications can be prescribed to help treat spastic quad CP. For muscle stiffness relief, benzodiazepines may be prescribed.Other times, physicians may opt to treat muscle stiffness with injections of medication.

Additionally, kids with spastic quad may begiven medication to treat secondary, associated conditions of CP, such as ADHD and epilepsy.There are a number of medications that can help control and reduce the frequency of seizures.

Surgery

Surgery is the last resort/ form of treatment for most forms of CP, but it can play alarge role for children with spastic quad CP. There are a number of different types ofsurgeries that are carried out in order to correct problems with shortened muscles, dislocated joints, and other issuesthat cause pain and impairment to children.

Since muscle stiffness is a huge part of the reason children with spastic quad have so many health issues,Selective Doral Rhizotomy (SDR) may be an option. SDR is a type of surgery that helpsrelax the muscles and improve mobility in variousareas of the body. Although this form of surgery has underwent a lot of scientific scrutiny, the Childrens Hospital of St. Louis states that its an excellent choice, given the results its shown.

SDR entails removing the lamina from the vertebrae via an inch-long incision on the lower back. A rubber pad is then inserted along the spinal cord in order to separate the motor from the sensory nerves.

Although there is no cure for spastic quad, therapies, along with medications and sometimes surgery, have given numerous children the chance to lead more productive lives with lessened pain.

Read this article:
Spastic Quadriplegia Cerebral Palsy | Cerebral Palsy Guidance