1. Spastic Diplegic
Cerebral Palsy
Irene Damico
14128052
Health Sciences Internship Final Project

2. Cerebral Palsy: general diagnosis
 Affects balance and posture
 “Cerebral” = “brain” that
experiences abnormal development
 “Palsy” = “paralysis” of muscles
 Very common childhood motor
disability diagnosis
 1 in every 323 children in the US
diagnosed with Cerebral Palsy
 In Missouri, 2.5/1000 eight year olds
have been diagnosed with Cerebral
Palsy (as shown to the right)
(Centers for Disease Control and Prevention, 2008)

3. Spastic Diplegic Cerebral Palsy
 “Spastic” = stiff muscles
 “Diplegic” = paralysis on both sides
of the body
 Typically affects lower limbs, and
can vary in severity from mobile to
severely debilitating
 Based on degree of damage to the
brain
 77.4% of Cerebral Palsy diagnoses
are incidences of Spastic Diplegic
Cerebral Palsy (CDC, 2008
 Risk factors for SDCP include, but
are not limited to:
 Multiple birth pregnancy
 Premature birth
 Maternal infections
 Infant seizures
 SDCP is one of nine different types
of Cerebral Palsy
(brainandspinalcord.org)
(brainandspinalcord.org)

4. Etiology
 The exact cause of many Spastic Diplegic Cerebral Palsy cases can be unclear
and can vary with each individual
 Spastic Diplegic Cerebral Palsy has multiple possible causes, including:
 Periventricular leukomalacia
 Cerebral dysgenesis
 Intracranial hemorrhage
 Asphyxia
 Damage leading to Spastic Diplegic Cerebral Palsy can occur before, during, or
after birth
National Institute of Neurological Disorders and Stroke

5. Pathophysiology: Periventricular Leukomalacia
 White matter brain damage
 Nerve dense tissue
 The primary communication
pathway between the brain and
the rest of the body
 Presents as holes in the brain
tissue surrounding the ventricles
 Damage by periventricular
leukomalacia obstructs nerve
signals, creating motor and other
neurological complications
A.D.A.M. Medical Illustration
Team
National Institute of Neurological Disorders and Stroke

6. Pathophysiology: Cerebral Dysgenesis
 Abnormal brain development
 Incomplete development
 Incomplete division of hemispheres
 Incomplete organization
 Abnormal growth
 Can lead to epilepsy, intellectual
and sensory impairment along with
Spastic Diplegic Cerebral Palsy
 Occurs as a result of infection,
genetics, fever, and/or trauma
Cerebralpalsy.org Medscape

7. Pathophysiology: Intracranial
Hemorrhage
 Brain bleed
 Arterial
 Added loss of oxygen, more difficult to treat
 Venous
 Can damage or cause the death of brain
tissue important for mental and motor
development
 Hematoma
 Localized bleeding that causes destructive
pressure on surrounding tissue
 Characterized by four grades
 I and II do not usually have lasting effects
 III and IV are more severe and can lead to
CP/SDCP
 Five different types of Intracranial
Hemorrhage
 Intraventricular hemorrhage
 High risk for the development of Cerebral Palsy
 Epidural hematoma
 Subdural hematoma
 Subarachnoid hematoma
 Intracerebral hemorrhage

8. Pathophysiology: Asphyxia
 Absence of oxygen to body and
brain, depending on duration may
or may not cause lasting issues
 Hypoxic-ischemic Encephalopathy
 Most common type of brain damage
caused by asphyxia
 Cause of only 9% of Cerebral Palsy
cases
 Asphyxia can lead to
periventricular leukomalacia
 Asphyxia an be caused by fetal
pulmonary and cardiac issues,
stroke, acute maternal
hypotension

9. Spastic Diplegic CP Symptoms
 Individuals with SDCP do not
typically have intellectual or
language skill difficulties
 Better ability to move hands than
individuals who have other types of
Cerebral Palsy, can still be difficult
 Arms and face generally
unaffected by SDCP
 Walk with a “scissored” gait
 Leg muscles vary in degree of
mobility
 Twisted feet and knees
 Stiff feet muscles
 Toes point upward
 Hyperactive tendon reflexes
 May require assistance of a walker
or leg braces
National Institute of Neurological Disorders and Stroke

10. Spastic Diplegic Cerebral Palsy:
Progression
 Individuals often exhibit signs of
premature aging
 Occupational issues
 Adults may experience difficulty at
work, require special hours,
additional rest
 Mental health
 Depression more likely because of
diagnosis, emotional support and
optimism seem effective in
combatting
 Post-impairment Syndrome
 Pain, fatigue, weakness
 Arthritis
 Osteoarthritis
 Degenerative arthritis
 Pain
 Worse for individuals with Spastic
Diplegic CP than other types of
Cerebral Palsy
National Institute of Neurological Disorders and Stroke

11. Treatment Options
Physical Therapy
 Prevents spastic muscle
contraction
 Strengthens muscles, prevents lack
of use
 Develop balance and motor skills
Recreational Therapy
 Helps with both physical and
cognitive skills
 Improvement in communication
 Encourages good self-esteem
 Promotes emotional well-being
National Institute of Neurological Disorders and Stroke

12. Adapted Gymnastics
 Parents report improvements in
children’s self-esteem and
communication skills as a result of
recreational therapy
 National Institute of Neurological
Disorders and Stroke
 Provides emotional and physical
support to children diagnosed with
Spastic Diplegic Cerebral Palsy
 Sense of accomplishment
 Fun and play time
 Increases morale and encourages
optimism, which may help prevent
depressive moods and thoughts
 Physical therapy students can
maneuver lower limbs to help a child
increase mobility and reduce pain
from Spastic Diplegic Cerebral Palsy
 Improves speech and communication
skills
 Learn how to ask for what they need
and want
 Provide feedback on the experience,
critical thinking skills

13. References
 "Cerebral Palsy: Hope Through Research.” National Institute of Neurological
Disorders and Stroke (NINDS). Web. 27 Apr. 2015.
 "Data & Statistics." Centers for Disease Control and Prevention. Centers for
Disease Control and Prevention, 03 Mar. 2015. Web. 27 Apr. 2015.
 "Imaging in Agenesis of the Corpus Callosum ." Imaging in Agenesis of the
Corpus Callosum. WebMD LLC, Web. 27 Apr. 2015.
 "Periventricular Leukomalacia." University of Maryland Medical Center. 17
June 2014. Web. 27 Apr. 2015.
 "Spastic Diplegia." Cerebral Plasy| Treatments, Causes , Diagnosis,
Complications. Brainandspinalcord.org, Web. 27 Apr. 2015.
 "Types of Cerebral Palsy | Forms of CP | CerebralPalsy.org."CerebralPalsyorg
Types of Cerebral Palsy. Web. 27 Apr. 2015.