Spastic diplegia or diplegic cerebral palsy is a form of cerebral palsy, which is a disease that occurs due to an anomaly in the brain that forms before, during or shortly after birth. Whilst it is characterized by paralysis of the lower limbs, it varies in severity and can sometimes reach the upper limbs. This syndrome mainly affects babies born prematurely, as well as those who experienced trauma during childbirth.
Historically known as Little's disease, spastic diplegia is one of the four types of an infantile neurological disease called cerebral palsy and it affects control of movements and co-ordination. Children born with this disease have paralysis of the lower limbs that varies in severity, and sometimes experience paralysis of the upper limbs.
The first signs of spastic diplegia are usually detected around the age of one, when psychomotor development abnormalities can first be assessed.
The disease is primarily characterized by paralysis of the lower – and in some cases, upper – limbs. While some children will be able to walk unaided, others will have to use a walker. In some cases, the children will never be able to walk and will have to use a wheelchair.
Apart from the paralysis, spastic diplegia manifests itself through other symptoms such as:
-Rigidity of the lower limbs (and sometimes upper limbs)
-Muscle spasms and seizures
-Delayed movement milestones (learning to walk, sit up, roll over etc.)
-Difficulty making certain movements and problems with fine motor skills
-Abnormal resting limbs
-Bone deformities (especially of the foot) that often cause pain in adulthood
Whilst symptoms can change throughout different stages of life, the condition does not progress or worsen overtime.
Spastic diplegia is caused by brain damage that mainly affects premature babies. Because of this, a pregnancy involving twins can be risky as they often lead to premature births. Difficulties during childbirth which result in the baby having an inadequate blood supply can also cause spastic diplegia. There are some circumstances or conditions which can make it more likely for a child to develop diplegic cerebral palsy:
-Premature birth or low weight at birth (less than 5.5lbs)
-Multiple births (twins, triplets or more)
-Infection or fever in mother
-Incompatible blood type between mother and infant
-Complications during labour and delivery
As brain damage is irreversible, there is no cure for spastic diplegia. However, early treatment can make life easier for children who are afflicted with the disease. Various professionals such as physiotherapists, speech therapists, psychomotor therapists, occupational therapists, and psychologists can help children with spastic diplegia develop motor skills. Rehabilitation, if maintained throughout their lifetime, can also reduce orthopedic deformities.
A surgical operation is recommended in some cases. Tendon lengthening and tenotomy can help with growth in early childhood. Injections of botulinum toxins can also be administered. Once the child is fully grown, surgery can be done on the hips, feet, knees, or spine to stabilize bone deformities and help maintain the ability to walk. However, operations are not recommended for adults who suffer from the disease as it can lead to loss of function.