Dyskinetic Cerebral Palsy Treatment India, Bangladesh, Nepal

 In Cerebral Palsy

Dyskinetic Cerebral Palsy

Dyskinetic cerebral palsy is defined as cerebral palsy with uncontrolled involuntary abnormal movements. In this type, the lesion is situated in basal ganglia. Most of the time it occurs because of kernicterous (high bilirubin level in blood) in pre term baby.

Diskynetic cerebral palsy can present in two different patterns including choreo-athetoid & dystonic. Dystonic cerebral palsy is characterized by slow movements with muscle rigidity & persistent abnormal posture during activity. Due to rigidity muscle, sore & pain is very common. Dystonic cerebral palsy usually affects the whole body (generalized dystonia) and may also affect muscles of speech, deglutition, facial expression, so it may be disabling with this problem. Rarely dystonic variety can affect one side of the body (hemidystonia), part of the body (focal dystonia) or neck (cervical dystonia). Choreoathetosis cerebral palsy is characterized by abrupt, irregular jerky movement (chorea) & slow writing movements of extremities (athetoid). Tone in athetoid CP is variable but usually it may be hypotonia or normal tone, so fix deformity is rare but these children can have an increase in movements (hyperkinesis). The child is fully relaxed during sleep and rest. Abnormal movements increase when he is in stress or some emotional outburst or attempts to perform some voluntary activities. Energy expenditures is much high in this variety because of continuous abnormal movement. Movements are quite disabling so it is very difficult to maintain posture & performing any task for ADL.

Constipation, regurgitation, contracture , regular fall, fast degeneration of joint, spondylitic changes in spine, radiating pain due to nerve compression are common complications which can develop in the due course of time. So it is imperative to look into all these possible complications at regular interval. These children are also prone to develop psychological & nutritional problems. In these children, benefit can be given by the use of relaxing exercise, different yoga posture, task-oriented exercise, brace. Some time oral medicines are also prescribed to control abnormal movements and tone of muscle. Children with dystonic cerebral palsy also utilize some sensory ticks to control movements for a while. In cervical dystonia, they use hands support below the chin to control neck movements.

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