The Facts:
For every 1,000 children born, there is a 0.015 to 0.5 percent chance that a birth injury will affect the child's nervous system and cause cerebral palsy (medically known as a static encephalopathy). Approximately 50 percent of these children will develop spastic cerebral palsy, while another 25 percent will have a mixed cerebral palsy with a spastic component.
A number of other sources of injury to infants and young children can also result in a fixed dysfunction or permanent impairment of the nervous system. They include:
- Head injuries
- Infections of the central nervous system
- Anoxic (cutoff of oxygen to the brain) episodes such as near-drowning
- Cerebrovascular accidents (stroke)
- Malnutrition
- Heavy metal ingestion
Any of these can result in static childhood spasticity. Progressive spasticity may be seen with degenerative encephalopathies (e.g., leukodystrophies) and tethered spinal cords as can occur with spinal dysraphisms.
Spasticity may be present in one of three forms in these children;
- Spastic diplegia (lower extremities more involved than uppers)
- Spastic quadriplegia (all four extremities involved equally
- Spastic hemiplegia (one side of the body involved)
Children born before 32 weeks’ gestation with a static encephalopathy will typically develop a spastic diplegia, or spasticity primarily in legs, while those born closer to term with a static encephalopathy will show a spastic quadriplegia pattern that impacts all four limbs. Children showing a spastic hemiplegia, or a one-sided spasticity, typically have a perinatal history of a grade IV intraventricular hemorrhage with the portion of the blood clot reaching brain tissue causing an injury. More recently, an increasing number of young children who sustained an injury to their nervous system around the time of birth are presenting with mixed forms of cerebral palsy, with more than one type of muscle tightness being present.