What is Spastic Diplegia?
Spastic diplegia is a form of spastic cerebral palsy that presents itself in the form of stiff, tight leg muscles, or exaggerated reflexes in the lower limbs. People with spastic diplegic cerebral palsy typically do not have impacted upper limbs. Spastic diplegia is a classification of cerebral palsy based on the Limb Involvement Classification System, which organizes cerebral palsy into types based on the location of limb impairment, as well as the number of limbs affected by the brain injury. “Spastic” refers to the form of motor disturbance present in this condition, and “diplegia” refers to the number and types of limbs involved.
How Does Spastic Diplegia Differ From Other Forms of Cerebral Palsy?
A primary difference between spastic diplegia and other forms of spastic cerebral palsy is the presence of a signature scissor gait. The scissor gait is characterized by:
- Locked hips and pelvis, as if crouching while walking
- Ankles turned inwards while walking
- Feet make contact with the ground at the ball of the foot, not the heel (may look like “tip-toeing”)
- Knees and thighs may cross or touch while walking
- Arms and hands may go outwards from the body to provide balance
What Causes Spastic Diplegia?
As with other forms of cerebral palsy, spastic diplegic cerebral palsy is caused by injury to the developing brain. These injuries may take the form of:
- HIE or other oxygen-depriving event during labor and delivery
- An infant intracranial hemorrhage (brain bleed), caused by vacuum extractors, forceps, or trauma during delivery
- A maternal infection passed from mother to baby that causes sepsis or meningitis
- Prematurity in combination with HIE, brain bleeds or infection.
Any of these injuries can lead to a disruption in communication between the brain’s neurons and the muscles in the body, causing them to be tight or spastic.
Important Signs and Symptoms for Diagnosis
Symptoms of spastic diplegia depend on the individual and the severity of his or her case. Common signs and symptoms of spastic diplegic cerebral palsy include:
- Muscular stiffness (hypertonia), especially in lower limbs
- Muscular weakness or floppiness (hypotonia), especially in lower limbs
- Abnormal muscle tone, reflexes, motor development, and coordination
- Permanently fixed or tight muscles
- Spasms and spastic movements or gestures
- Use of only upper limbs to move around, instead of crawling with both arms and legs
- Unsteady movement and poor balance
- Continual hunched sitting posture
- Scissor walking
While newborns with complicated labor and delivery processes (HIE, infection, brain hemorrhage, etc.) are often classified as “high-risk” for cerebral palsy at birth, a formal diagnosis of spastic diplegia may take months or years. This delay is due to the fact that the primary symptoms of this injury are seen in the legs, and children must show the difficulties in development of lower limb use before the diagnosis can be made.
Treatment and Therapy for Spastic Diplegia
Therapeutic treatment for children with spastic diplegia is available, and is implemented on a number of fronts. A child’s physician should work closely with a physical therapist, occupational therapist, and speech therapist to ensure that a child’s care is well-rounded and suited to the individual’s needs. Care for spastic diplegia should be comprehensive, however, the different domains of care are administered by professionals with different specialties. The various domains of care include:
- Physical Therapy: This category of treatment works to promote motor and developmental skills. There are various forms of physical therapy put into use by professionals, such as:
- Daily Range-of-Motion (ROM) Exercise, which work to prevent or delay contractures caused by spasticity, and to maintain the mobility of joints and soft tissues.
- Hippotherapy, or Horseback Riding Therapy, which helps improve muscle tone, ROM, strength, coordination, and balance. In addition, there are many social and emotional benefits to this therapy.
- Kinesio Taping or Elastic Therapeutic Taping, which works to re-educate muscles for stretching and strengthening.
- Aquatic Therapy and Electrical Stimulation, which can be used strengthen muscles and increase muscle size.
- Occupational Therapy: This is a domain of treatment that focuses on the activities of daily life, such as feeding, dressing, and grooming.
- Speech Therapy: This form of therapy can be used to improve swallowing and communication for those who need it
Legal Help For Cerebral Palsy | Detroit, Michigan Birth Injury Attorneys Representing Victims Of Medical Malpractice
If your loved one was diagnosed with spastic diplegia, or another form of cerebral palsy, through an act of medical malpractice, we encourage you to reach out to the birth injury legal team at Reiter & Walsh ABC Law Centers today. Our team of cerebral palsy and birth injury lawyers will hold a free legal consultation with you and determine your legal options.
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