Spastic quadriplegia is considered the most serious type of cerebral palsy, largely due to the fact it is the most disabling. Spastic quadriplegia is characterized by stiff or contracted muscles in all four limbs. In the most severe cases, those with this type of cerebral palsy have very limited mobility and are sometimes unable to walk.

Symptoms of spastic quadriplegia include stiffness in both the arms and legs and floppiness in the neck and trunk. Speech is often impaired and seizures are common. Since this type of cerebral palsy can affect intelligence, mental retardation may also be present. Spastic quadriplegia may also affect digestion, hearing, and vision. Other symptoms of the condition include incontinence, increased drooling, trouble sleeping, and slower than normal growth.

What Causes Spastic Quadriplegia? 

While it is well-known extensive brain damage causes spastic quadriplegia, there are many unknowns as to what causes the brain damage. Some research suggests brain damage is caused when a mother develops an intrauterine infection while pregnant. This is especially true of a specific type of brain damage called periventricular leukomalacia (PVL). Periventricular refers to the area around the ventricles of the brain. Leuko means white and in this instance refers to the brain’s white matter. The term malacia means softening of the tissues. When there is an intrauterine infection present in the mother, toxins can travel through amniotic fluid and injure parts of the brain. Most babies who develop PVL are born before 30 weeks gestation.[1]

Other causes of brain damage include:

  • Blood clots in the placenta that cause fetal strokes
  • Weakened blood vessels in the developing baby’s brain
  • The mother having high blood pressure during pregnancy
  • Other maternal infections such as inflammatory pelvic disease
  • A lack of oxygen to the baby’s brain while in utero or shortly before, after, or during birth

One of the only ways PVL and other types of brain damage are detected in infants is by cranial ultrasounds, magnetic resonance imaging (MRI), or computed tomography (CT) scans. The brain damage might not appear on the scans right away, however, which is why repeat scans are often performed. These types of tests are usually standard for premature babies since they are more susceptible to brain damage. An actual diagnosis of spastic quadriplegia usually cannot be determined until the infant is older. If babies are behind in their development or begin having seizures, these may be signs of this type of cerebral palsy.

What Parts of the Body are Affected? 

Another sign of spastic quadriplegia is hypertonia in the arms and legs. This stiffness of joints is also referred to as high muscle tone. Besides having hypertonia in the arms and legs, there is oftentimes hypotonia in the trunk and neck. This means there is low muscle tone that causes the head to flop to the side and can interfere with the ability to sit up without assistance.

When it comes to spastic quadriplegia, the word spastic generally means something that relates to or is affected by a muscle spasm. The term quad comes from Latin for four and plegia is Greek for having the inability to move. The term “quadriplegia” can be confusing when describing a person with cerebral palsy. When one thinks about a quadriplegic, they might think of someone who can’t move at all. They are right to think this because there is another type of quadriplegia in which this is the case. This diagnosis is due to a spinal cord injury and affects spinal nerves C1-C8 causing paralysis in all four limbs. [2]

For someone with spastic quadriplegia, it simply means all four limbs are affected by spasticity. The person can still move their arms and legs but they cannot move them purposefully. This is due to a lack of communication between the brain and the muscles due to the parts of the brain that were damaged.

What are Treatment Options for Spastic Quadriplegia? 

As with all types of cerebral palsy, there is no cure for spastic quadriplegia. There are however, some treatment options available that can help to relieve its symptoms. Upon diagnosis, doctors will usually recommend for a baby to get involved in pediatric physical therapy and occupational therapy right away. Other types of therapy that have been known to help children with spastic quadriplegia include:

  • Hydrotherapy (physical therapy done in the water)
  • Hippotherapy (therapy on horseback)
  • Speech therapy
  • Music therapy
  • Massage therapy

Other treatment options include stretches, surgery, Botox, baclofen, wearing ankle-foot orthotics (AFOs), and chiropractic care.

Sources:

PVL: http://www.stanfordchildrens.org/en/topic/default?id=periventricular-leukomalacia-pvl-90-P02619

Quadrepligia: http://www.apparelyzed.com/paralysis.html

Footnotes:
[1]  –  http://www.stanfordchildrens.org/en/topic/default?id=periventricular-leukomalacia-pvl-90-P02619
[
2] – http://www.apparelyzed.com/paralysis.html