Spastic Cerebral Palsy
Spastic cerebral palsy is the most common type of cerebral palsy, affecting about 70–80% of all diagnosed cases. It is caused by damage to parts of the brain that control muscle movement, leading to stiffness, tightness, and difficulty with coordination. Understanding its causes, symptoms, and treatment options can help families make informed decisions and improve quality of life.
What is Spastic Cerebral Palsy?
Spastic cerebral palsy (CP) is the most common type of cerebral palsy, affecting 70–80% of people with the condition. It results from brain damage that disrupts communication between the brain and muscles, causing abnormal muscle tightness, known as spasticity. This stiffness makes it harder to move, stretch, or control muscles, and can impact everything from walking to grasping objects. Movements often appear jerky or awkward because the muscles cannot relax properly. Unlike other forms of CP, spastic CP is defined specifically by persistent muscle stiffness and reduced flexibility.
What Causes Spastic Cerebral Palsy?
Spastic cerebral palsy occurs when specific areas of the brain that control movement are damaged. The motor cortex, located at the top of the brain, sends signals to the muscles to produce voluntary movements like walking, reaching, or grasping.
Damage to this area disrupts the smooth coordination of these signals, leading to stiffness and difficulty controlling muscle movement. The pyramidal tracts, which are bundles of nerve fibers connecting the motor cortex to the spinal cord, transmit these movement commands to the muscles.
When these tracts are injured, messages from the brain may become weak, delayed, or misdirected, causing muscles to contract abnormally. Other supporting regions, like the basal ganglia, help regulate movement intensity and prevent excessive muscle activity; damage here can increase spasticity.
Nearly 70% of cerebral palsy cases are linked to birth injuries. Find out if a birth injury caused your child's CP by speaking with a cerebral palsy lawyer and getting a free case review now.
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Spastic Cerebral Palsy Risk Factors
Certain conditions and circumstances can increase the likelihood of a child developing cerebral palsy, though they do not directly cause the brain injury that leads to spastic CP.
These factors often affect brain development or make the nervous system more vulnerable to damage. While some risk factors are present before birth, others can occur during or shortly after delivery.
Potential risk factors include:
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Premature birth: Babies born before 37 weeks have underdeveloped brains that are more susceptible to injury. The earlier the birth, the higher the risk of complications affecting movement.
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Low birth weight: Infants weighing less than 5.5 pounds are at greater risk because their organs and nervous system may not be fully developed. Low birth weight can make the brain more fragile and sensitive to injury.
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Multiple births: Twins, triplets, or higher-order multiples are more likely to experience growth restrictions or birth complications. These factors can increase the chance of brain damage that leads to CP.
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Maternal health issues: Conditions like high blood pressure, diabetes, infections, or thyroid disorders during pregnancy can affect fetal brain development. Managing these conditions carefully may reduce risk.
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Placental problems: The placenta delivers oxygen and nutrients to the developing fetus. Issues like placental abruption or insufficient blood flow can compromise brain development.
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Complicated labor or delivery: While not the only cause, difficulties such as prolonged labor or abnormal presentation can increase stress on the baby’s brain. Close monitoring during labor can help minimize potential harm.
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Severe jaundice in newborns: High levels of bilirubin can be toxic to the brain if untreated. Prompt medical care for jaundice lowers the risk of lasting damage.
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Infections in the mother or newborn: Some infections can interfere with brain development or trigger inflammation. Early detection and treatment help reduce potential harm.
Having one or more risk factors does not mean a child will develop cerebral palsy, but it may increase the likelihood of getting it.
Signs & Symptoms
Symptoms of spastic cerebral palsy most often include muscle stiffness that interferes with smooth, controlled movement. Children may walk on their toes, cross their knees, or move with a scissoring gait. Reflexes may be exaggerated, causing sudden or jerky motions. Motor skill development may be delayed, with rolling, sitting, or crawling happening later than expected. Without intervention, spasticity can lead to pain, fatigue, and joint deformities.
Additional symptoms may include:
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Pain or discomfort from tight muscles
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Difficulty with fine motor skills
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Increased stiffness during growth spurts
Subtypes of Spastic Cerebral Palsy
Doctors will also classify spastic cerebral palsy into different subtypes, based on which areas of the body or limbs are affected. These classifications are called diplegia, hemiplegia, and quadriplegia, with triplegia, and monoplegia being more rare.
The effects of each type include:
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Spastic Diplegia – mainly impacts the legs, making walking difficult but leaving the arms less affected.
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Spastic Hemiplegia – affects one side of the body, often with more stiffness in the arm than the leg.
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Spastic Quadriplegia – is the most severe, involving all four limbs, the trunk, and sometimes the face.
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Triplegia – three limbs are affected, can be either two legs and one arm, or the two arms and one leg.
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Monoplegia – affects one limb, either the arm or leg.
Severity Levels
The overall motor function for children spastic cerebral palsy can range from mild to severe, and doctors often use the Gross Motor Function Classification System (GMFCS) to assess a child's mobility.
A child at Level I can walk without any limitations, while Level V requires full support for movement. These levels help guide therapy plans and adaptive equipment needs. Even those with more severe symptoms can improve independence with early treatment.
(GMFCS) Levels
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Level I – Walks without any limitations
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Level II – Walks with some difficulty
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Level III – Uses crutches or walker
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Level IV – Primarily uses a wheelchair
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Level V – Limited voluntary movement, requires full assistance
Diagnosis
Diagnosis begins with a thorough medical history and physical examination. Doctors look for signs of spasticity by testing muscle tone, reflexes, and movement control.
Brain imaging, such as MRI or CT scans, helps confirm injury to motor-control areas. Developmental delays are tracked to see if milestones like crawling or walking occur later than expected. Early and accurate diagnosis ensures therapy can start when it’s most effective.
Complications & Associated Conditions
If untreated, spastic CP can lead to muscle shortening (contractures), bone deformities, and joint problems. Uneven muscle pull may cause hip dislocation or spinal curvature. Some children experience seizures, learning delays, or sensory problems like vision and hearing loss. These conditions often require their own treatment alongside CP care. Addressing complications early prevents more serious health issues later.
Common complications include:
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Muscle contractures
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Joint deformities
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Hip dislocation
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Scoliosis
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Seizures or sensory impairments
Cerebral palsy malpractice cases often have settlements over $1 million. If your child's cerebral palsy was caused by a preventable birth injury, you may qualify for legal compensation. Check if you're eligible by getting a free case review now.
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Treatment & Management
While spastic cerebral palsy has no cure, there are multiple treatment options that can significantly improve muscle function, mobility, and quality of life. Care is usually customized for each person and may include a mix of therapies, medications, and surgical procedures.
Below are some important treatments used for spastic CP.
Physical Therapy
Physical therapy is the foundation of spastic CP treatment, focusing on improving muscle strength, flexibility, and coordination.
Therapists design stretching and strengthening routines to reduce stiffness and prevent contractures.Sessions may also teach balance skills and proper walking patterns to avoid long-term joint damage.
Hydrotherapy (water-based exercise) is sometimes used to make movement easier. Regular therapy, especially during growth phases, can help maintain mobility over a lifetime.
Occupational Therapy
Occupational therapy helps children and adults with CP develop the skills needed for everyday tasks like eating, dressing, and writing.
Therapists may recommend adaptive tools, such as utensils with larger handles or modified desks, to make activities easier. Training often includes fine motor exercises to improve hand control and reduce fatigue.
Therapy can also focus on building independence in school, work, and home settings.
Medications for Muscle Spasticity
Medications are often used alongside therapy to reduce excessive muscle tightness. Baclofen, diazepam, and tizanidine are used to relax muscles and improve comfort, while Botox injections target specific overactive muscles.
Botox is especially effective for localized stiffness and may prevent the need for early surgery. Oral medications work more generally but may have side effects such as drowsiness. The right medication plan depends on symptom severity and patient tolerance.
Surgeries
Surgery is sometimes needed when spastic cerebral palsy causes severe muscle tightness, joint deformities, or mobility problems that cannot be managed with therapy and medication alone.
These procedures aim to reduce spasticity, correct bone or muscle abnormalities, and improve overall movement and comfort.
Common surgeries for spastic cerebral palsy include:
- Selective Dorsal Rhizotomy (SDR): This surgery reduces leg muscle stiffness by cutting overactive nerve fibers in the spinal cord.
- Tendon Lengthening (Achilles tendon lengthening, hamstring lengthening): These procedures loosen tight tendons to improve joint flexibility and walking ability.
- Adductor Release Surgery: This surgery releases tight inner thigh muscles to prevent hip dislocation and improve leg alignment.
- Osteotomy: Osteotomy reshapes or repositions bones to correct deformities and improve joint function.
- Spinal Fusion Surgery: This procedure stabilizes and straightens the spine in cases of severe scoliosis caused by spasticity.
- Intrathecal Baclofen Pump Implantation: A small pump is implanted to deliver medication directly into the spinal fluid to reduce overall muscle spasticity.
Assistive Devices & Mobility Aids
Assistive devices allow people with spastic CP to move more safely and participate more fully in daily life. These tools are chosen based on the person’s strength, balance, and activity level.
Mobility aids can be either temporary for rehabilitation or permanent for those with more severe mobility limits.
Common devices include:
- Braces, walkers, crutches, and wheelchairs can help people with spastic CP move more safely and independently.
- Orthotic devices support proper joint alignment, prevent muscle shortening, and improve walking efficiency.
Getting early intervention for cerebral palsy is crucial because the brain and muscles are most adaptable in early childhood.
Starting therapy soon after diagnosis helps children develop strength, coordination, and flexibility before patterns of stiffness and limited movement become fixed, which can improve the child's future quality of life.
Daily Life Impact & Prognosis
Spastic CP can affect learning, mobility, and independence, but outcomes vary widely. Children with mild symptoms may walk and live independently, while more severe cases may require lifelong mobility aids and support.
School accommodations, home modifications, and assistive technology can make daily activities easier. With early therapy and consistent care, many people maintain good health and active participation in their communities.
While CP is permanent, long-term quality of life can be high with the right support network.
Legal & Financial Resources
If your child’s cerebral palsy was caused by a preventable medical mistake during pregnancy, labor, or delivery, you may have legal options. Birth injuries linked to negligence can create lifelong medical and financial challenges, but compensation can help cover therapy, equipment, and long-term care.
Families who pursue a claim often secure resources that ease the burden of ongoing treatment. No parent should face these challenges alone or without the support they deserve. Get a free case review to help understand your rights and whether your family may qualify for compensation.
The average lifetime cost to care for a child with cerebral palsy is over $1.6 million. Find out if your child is eligible for legal compensation. Get a free case review now.
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Spastic Cerebral Palsy FAQs
Written and Medically Reviewed by:
Cerebral Palsy Hub Team
Cerebral Palsy Hub was founded to help support children and their families with cerebral palsy and to create a safe space for those affected. We strive to provide the most accurate, up-to-date information, and tools to help give your child the life they deserve.
Last Updated: September 2, 2025
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