Diplegic cerebral palsy (CP), also known as spastic diplegia, is a form of cerebral palsy marked by tense muscles and spasms. Leg muscles in particular tend to be extremely tight, and over time, this causes joints to stiffen, reducing the range of motion. Diplegic CP is considered one of the milder forms of the disorder, and most children’s intelligence and cognitive functions are not severely affected, although they may take longer to reach intellectual milestones.
Causes of Diplegic Cerebral Palsy
Neonatal asphyxia is the most common cause of diplegic CP, which generally happens when a newborn is deprived of oxygen during the delivery process. Infants born prematurely and with low birth weight have a heightened risk of developing diplegic CP as these babies are prone to oxygen problems during birth. Maternal infections, such as a high-grade fever or rubella during pregnancy also play a role in an infant develop diplegic CP.
Symptoms and Characteristics of Diplegic Cerebral Palsy
Depending upon each individual, symptoms and characteristics of diplegic CP will range from mild to severe. The most common symptoms and characteristics include:
- During infancy, babies may use their upper limbs to move around instead using their legs and arms to crawl. Additionally, some infants may not crawl at all.
- Between 1 to 3 years of age, infants and toddlers may prefer to sit in a “W” shape. However, doctors recommend helping your child practice sitting cross-legged for posture practice.
- Some children may not be able to stand alone by 3 years of age. In these instance, a stander or an ankle-foot brace may be recommended by your doctor.
- When children begin to walk, they may walk with their feet turned inward or they may roll their feet.
- Spastic hip disease is common and can gradually increase to hip dislocation and joint problems as the child grows older.
- Most children with diplegic CP can only walk short distances.
- Leg muscles may go from stiff and rigid to floppy and relaxed.
Diplegic Cerebral Palsy Diagnosis
Although an infant can be assessed at birth as high-risk for CP because of asphyxia, it may be several months or years before a formal diagnosis of diplegic CP can be made. The diagnosis takes longer due to the primary symptoms affecting the legs. Children must first show signs of leg movement difficulties and developmental delays before a proper diagnosis can be made.
Diplegic Cerebral Palsy Treatment
As with most other forms of CP, children with diplegic CP greatly benefit from physical therapy. Physical therapy not only helps strengthen muscles but it also helps with balance, coordination, and daily living tasks. In addition to physical therapy, many parents opt to have their children undergo massage therapy, which can begin as early as infancy. Massaging helps to relieve pain and reduce the muscle stiffness associated with diplegic CP.
Doctors may also prescribe medication that helps to decrease muscle spasms and stiffness, such as baclofen. In instances in which medication isn’t enough to reduce the pain, yoru doctor may recommend orthopedic surgery. Orthopedic surgery is the most common type of surgery for children who have CP and entails correcting walking difficulties and unmanageable stiffness. According to the National Institute of Disorders and Stroke (NIH), children must be at least 2 to 4 years of age before undergoing orthopedic surgery and must have major obstacles in their motor skills development.
Diplegic Cerebral Palsy Prognosis
Per the U.S. National Library of Medicine (NCBI), prognosis is favorable for children with diplegic CP. As previously mentioned, diplegic CP is the least invasive type of CP, affecting mainly the legs. However, since hip dislocation is common, it’s highly recommended that people with diplegic CP begin regular hip check-ups as soon as possible.