Types & Classifications of Cerebral Palsy
This page has been written, edited, and reviewed by a team of legal writers following our comprehensive editorial guidelines. This page was approved by Founding Partner, Terry Crouppen who has more than 40 years of legal experience as a personal injury attorney. Our last modified date shows when this page was last reviewed.
This page has been written, edited, and reviewed by a team of legal writers following our comprehensive editorial guidelines. This page was approved by Founding Partner, Terry Crouppen who has more than 40 years of legal experience as a personal injury attorney. Our last modified date shows when this page was last reviewed.
- Last Modified:
- April 18, 2024
Cerebral palsy, or CP, can look very different from one child to another. If you have a child who received a CP diagnosis, or you are pursuing or preparing for diagnosis, it’s vital to know how the condition presents.
There are four basic types of cerebral palsy. Within those types, subtypes and severity levels indicate a child’s needs. At Brown & Crouppen, our skilled attorneys can explain how the clinical picture determines your legal options.
Different Types of Cerebral Palsy
Cerebral palsy is the most common motor disability among children. According to the U.S. Centers for Disease Control and Prevention, approximately one in 345 children have some form of cerebral palsy. Most of those children have a co-occurring condition, with autism and epilepsy as the most prevalent.
Cases of cerebral palsy typically fall into one of four categories. Each type affects the body differently and could be anywhere along the severity spectrum.
Spastic Cerebral Palsy
Spasctic cerebral palsy is the most common type of the condition, affecting between 75 and 85 percent of diagnosed individuals. People with spastic cerebral palsy have chronic muscle tension, which makes coordination difficult and leads to a twitchy, lurching movement pattern.
There are three subtypes of spastic cerebral palsy, differentiated by which body parts the condition affects. Those subtypes are:
- Spastic hemiplegia/hemiparesis: This subtype is marked by stiffness in the arm, hand, and occasionally leg on one side of the body. Intellectual development is typically normal, but children with this subtype may reach verbal milestones later than their peers.
- Spastic diplegia/diparesis: This subtype is characterized by muscle tension in the legs and somewhat less in the arms and face. Children generally reach language milestones on a typical timeline. Intellectual development is usually normal.
- Spastic quadriplegia/quadriparesis: This manifests as severe stiffness in the extremities and a weak neck. Spastic quadriplegia is a highly severe cerebral palsy form. Children with this subtype usually struggle in multiple development domains.
Dyskinetic Cerebral Palsy
Approximately 15 percent of people with CP have its dyskinetic form. Dyskinetic cerebral palsy causes uncontrollable arm, hand, leg, and foot movements. Depending on the level of muscle stiffness, these compulsive movements may be quick or slow. Muscle tone can shift from extremely tight to excessively loose, sometimes varying within a day.
Dyskinetic cerebral palsy may also affect the tongue and facial muscles, causing unintentional facial grimaces or difficulty eating, drinking, swallowing, or talking. Swallowing difficulties may cause involuntary drooling. Children with this subtype usually show normal intellectual abilities.
Ataxic Cerebral Palsy
Ataxic is the rarest cerebral palsy form, affecting only 5 percent of diagnosed individuals. It causes difficulties with depth perception, balance, and coordination, including an unsteady gait. People with this subtype often struggle with precise hand and arm movements such as writing, reaching for objects, or manipulating clothing.
Mixed Cerebral Palsy
Those who show signs of more than one CP type have mixed cerebral palsy. The relevant cerebral palsy types may be part of the diagnosis.
For instance, the most common form of mixed cerebral palsy is spastic-dyskinetic CP. Symptoms include chronic muscle tension and uncontrolled body movements.
Classifying Cerebral Palsy
Cerebral palsy classification is vital for medical, social, and legal reasons. In a medical sense, it helps health care and therapeutic teams determine the most appropriate care level. Socially, it assists families in understanding their loved ones’ needs and supports parents’ advocacy for their children.
Classifications also help families understand their options for cerebral palsy lawsuits. To calculate financial losses, parents and attorneys need to know the extent of the condition and how much support a child will need.
Determining how many cerebral palsy types a child has depends on which classification system you use. Options include classifying by symptom severity, affected body region, and motor function level.
Classification by Severity Level
Severity-based classifications support communication among parents, teachers, and other support personnel. They focus on the assistance level the person with CP will need to care for themselves if self-care is possible.
There are four cerebral palsy levels:
- Mild: The person does not need adaptive tools to accomplish daily tasks. They can walk and move independently.
- Moderate: The person needs braces, medications, or other physical supports to accomplish daily tasks.
- Severe: The person relies on a wheelchair and needs significant help participating in daily life.
- No CP: Signs of cerebral palsy developed from an injury or illness suffered after the child’s brain developed. The person’s health records attribute movement difficulties to that incident.
These descriptions are only part of the clinical picture. Health care professionals and legal teams usually use additional cerebral palsy classifications to fully understand a patient’s needs.
Classification by Part of Body Affected
An accurate description of cerebral palsy includes the affected body areas. Classifying the condition this way creates nine forms of cerebral palsy based on the degree of limitations on each body part:
- Monoplegia/monoparesis: One arm or leg affected
- Paraplegia/paraparesis: Lower half of the body affected
- Diplegia/diparesis: Legs affected, arms affected to a lesser degree
- Hemiplegia/hemiparesis: Limbs affected on one side of the body
- Double hemiplegia/double hemiparesis: Affects all four limbs, one side more severely
- Triplegia/triparesis: Three limbs affected, or one upper limb, one lower limb, and the face affected
- Quadriplegia/quadriparesis: All four limbs affected
- Tetraplegia/tetraparesis: All four limbs affected, one to a lesser degree
- Pentaplegia/pentaparesis: All four limbs plus neck and head affected, with eating and breathing issues often present
These classifications help describe the degree to which cerebral palsy affects a person. They provide more clinical specificity than the severity scale, but we still need a clear picture of the case’s presentation.
Classification by Gross Motor Function Classification System
The Gross Motor Function Classification System, or GMFCS, identifies five cerebral palsy stages. Each stage includes a detailed description of a child’s motor function and what mobility aids they typically need.
The GMFCS applies to children ages 2 through 18 with age group divisions from 2 to 4, 4 to 6, 6 to 12, and 12 to 18 years. The system specifies what a child can do and what support they need within each age range. For example, by age six to 12, a child in each grouping can do the following:
- GMFCS I: Walk independently, climb stairs without railings, and run and jump
- GMFCS II: Walk with limitations in certain scenarios and climb stairs with a railing
- GMFCS III: Walk short distances with a mobility device, use wheeled mobility in the community, and climb stairs with assistance
- GMFCS IV: Use wheeled power mobility or assisted manual mobility but may have some ability to walk, crawl, or roll with assistance
- GMFCS V: May become independent with powered mobility aids and adaptations but needs ongoing assistance
The GMFCS is a relatively stable rating system. A child’s rating at age 12 is likely the same as their adult rating. Care teams, families, and cerebral palsy lawyers can typically rely on this system to predict support needs and estimate ongoing costs.
What Is the Most Severe Form of Cerebral Palsy?
The most severe form of cerebral palsy is spastic quadriplegia. Children with this subtype typically cannot walk and struggle to speak. Many also live with intellectual or developmental disabilities.
Children with severe cerebral palsy have extremely high care costs. Researchers have estimated that caring for a nonambulatory child with CP costs an average of $43,687 per year, more than four times the care cost for an ambulatory child.
What Legal Help Is Available?
When your child receives a diagnosis of cerebral palsy, affording high-quality care becomes a priority. Children with cerebral palsy typically need short-term treatment. Many need daily support for life. Those expenses quickly become prohibitive.
If you believe a birth injury may have caused your child’s cerebral palsy, contact Brown & Crouppen to discuss your legal options. We are an award-winning personal injury law firm that the St. Louis Post-Dispatch has named the “Best Law Firm in St. Louis.” We have won over $1 billion in life-changing awards for thousands of clients and families and are dedicated to providing the best representation for every client.
We have worked with many families living with CP. Thanks to our strong culture of community outreach, many of our attorneys also have volunteered with United Cerebral Palsy. All families deserve access to skilled legal representation, especially concerning a child’s well-being.
If you believe your loved one contracted cerebral palsy from a birth injury or other medical negligence, call 800-536-4357 or contact
Get started with a free consultation with one of our skilled Personal Injury Lawyers today.
Sources
Centers for Disease Control and Prevention. (2023, February 23). 11 things to know about cerebral palsy. Centers for Disease Control and Prevention. https://www.cdc.gov/ncbddd/cp/features/cerebral-palsy-11-things.html
Centers for Disease Control and Prevention. (2024, February 28). What is cerebral palsy? Centers for Disease Control and Prevention. https://www.cdc.gov/ncbddd/cp/facts.html
Ferluga, E. D. (2011). Table 1, CP classification systems used and understood by qualified medical practitioners* – interventions for feeding and nutrition in Cerebral Palsy – NCBI Bookshelf. Interventions for Feeding and Nutrition in Cerebral Palsy [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK132431/table/introduction.t1/
Paulson, A., & Vargus-Adams, J. (2017). Overview of four functional classification systems commonly used in cerebral palsy. Children, 4(4), 30. https://doi.org/10.3390/children4040030
Pulgar, S., Bains, S., Gooch, J., Chambers, H., Noritz, G. H., Wright, E., Sawhney, T. G., Pyenson, B., & Ferro, C. (2019). Prevalence, patterns, and cost of care for children with cerebral palsy enrolled in Medicaid Managed Care. Journal of Managed Care & Specialty Pharmacy, 25(7), 817–822. https://doi.org/10.18553/jmcp.2019.25.7.817
U.S. Department of Health and Human Services. (2021, May 11). What are the types of cerebral palsy? Eunice Kennedy Shriver National Institute of Child Health and Human Development. https://www.nichd.nih.gov/health/topics/cerebral-palsy/conditioninfo/types
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