Athetoid cerebral palsy, also known as dyskinetic cerebral palsy or ADCP, or alternately as dystonic or choreathetoid CP, occurs when the basal ganglia of the brain is damaged. The basal ganglia, located on the base of the forebrain, helps to control procedural learning, eye movement, voluntary muscle movements, emotions, and cognition. When damaged, dyskinesia, dystonia, and athetosis may occur, all symptoms and characteristics of ADCP.
Characteristics and Symptoms of Athetoid and Dyskinetic Cerebral Palsy
ADCP characteristics are separated into different groups, and while one child may suffer from a wide range of disabilities, others may only exhibit mild forms.
According to the National Institute of Neurological Disorders and Stroke (NIH), dystonia is defined as a disorder that affects voluntary muscle movement that’s marked by abnormal posture. Symptoms and characteristics include:
- Prolonged and repetitive movements
- Movements that change from slow to rapid
- Pain when moving muscles
- Involuntary movements which are more pronounced when tired, anxious, upset, or tense
- Touching the chin or face before attempting to move
- Placing a hand behind the head or under the chin before attempting to move and/or
- Placing the back of the head on a wall before attempting to move
Any part of the body can be affected by dystonia, but again, this will depend upon the child and their individual circumstances. For example, some children may exhibit dystonia characteristics all over the body, known as general dystonia, whereas others may exhibit symptoms only in one leg or in one foot, known as focal dystonia. In addition, some people have dystonia symptoms on only one side of the body, known as hemidystonia, or in the neck muscles only, known as cervical dystonia.
Athetosis is characterized by the child’s body either becoming extremely stiff or extremely relaxed. Involuntary movements typically accompany these body changes. Other characteristics and symptoms include:
- Noticeable involuntary muscle movements that makes the person appear to be constantly on the move
- Involuntary lip and tongue movement, which affects speech, eating, and drinking
- Involuntary movements usually only disappear when fully relaxed and asleep
- Difficulties holding objects such as spoons, forks, or writing utensils
- Increase in involuntary movements when under stress or upset
- Drooling due to involuntary face muscle movement
Involuntary muscle movements can affect the child’s entire body, making it difficult to perform simple takes such as shaking hands or scratching their nose.
Physicians typically diagnosis ADCP via assessment tools and tests that measure motor functions and developmental delays. The most common form of testing used is the gross motor functioning classification system (GMFCS).
Physicians also measure brain abnormalities in the basal ganglia that are associated with ADCP via magnetic reasoning imaging (MRI).
ADCP Treatment Options
As with all forms of cerebral palsy, there is no known cure for ADCP, but there are a number of treatment options that will help your child with motor skills, cognitive skills, and better daily living skills, including:
- Physical therapy
- Occupational therapy
- Medication that reduces spasms and involuntary movements
- Deep brain stimulation (DBS)
Those prognosis for those with ADCP is often difficult as it entirely depends upon the location of the brain lesions as well as the severity of the symptoms. Like many other forms of cerebral palsy, most people have to “wait and see” what treatment works best. However, over half of all people diagnosed with ADCP will go on to successfully engage in light activities. Speech problems typically affect people with ADCP for life.