Cerebral Palsy (cont.)

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What is hypotonic cerebral palsy?

Hypotonia is diminished muscle tone. The infant or child with hypotonic cerebral palsy appears floppy -- like a rag doll. In early infancy, hypotonia can be easily seen by the inability of the infant to gain any head control when pulled by the arms to a sitting position (this symptom is often referred to as head lag). Children with severe hypotonia may have the most difficulty of all children with cerebral palsy in attaining motor skill milestones and normal cognitive development.

Hypotonic cerebral palsy is often the result of severe brain damage or malformations. It is believed that hypotonic cerebral palsy is the result of an injury or malformation at an earlier brain developmental stage than that which causes spastic or choreoathetoid cerebral palsy.

Hypotonia in infancy is a common finding in many neurological conditions, ranging from very mild abnormalities to severe or even fatal neurodegenerative or muscle disorders. It is important to note that many children with spastic cerebral palsy go through a short stage of being somewhat hypotonic in early life, before presenting the full syndrome.

What is mixed cerebral palsy?

Many (possibly most) children with cerebral palsy have multiple symptoms with combinations of the various forms of cerebral palsy. For example, children with spastic cerebral palsy often continue to have a head lag, which is representative of hypotonia. Children with choreoathetoid or hypotonic cerebral palsy often have increased deep tendon reflexes, which are suggestive of some spasticity. Children with bilateral spastic cerebral palsy may also have dystonic movements in the limbs affected. The different types of cerebral palsy described above are rarely seen as pure clinical forms, more often the child with cerebral palsy has a mixture of signs or symptoms. Nevertheless, in clinical practice the type of cerebral palsy is defined on the basis of the predominant manifestations.


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