Dyskinetic cerebral palsy results from damage to the basal ganglia of the brain. The basal ganglia is like the brain’s switchboard for interpreting messages between the movement centre and the spinal cord – it is responsible for regulating voluntary movements. The different forms of dyskinesia result from damage to slightly different structures within the basal ganglia.
Dyskinetic movements can be:
- Twisting and repetitive movements – known as dystonia
- Slow, ‘stormy’ movements – known as athetosis
- Dance-like irregular, unpredictable movements – known as chorea.
- Dyskinetic movements often co-occur alongside spasticity.
What causes dyskinesia?
Dyskinetic cerebral palsy results from damage to the basal ganglia of the brain. The basal ganglia is like the brain’s switchboard for interpreting messages between the movement centre and the spinal chord – it is responsible for regulating voluntary movements.
The different forms of dyskinesia result from damage to slightly different structures within the basal ganglia.
Dystonia is characterised by involuntary muscle contractions that result in slow twisting or repetitive movements, or abnormal sustained postures, that are triggered by attempts to move.
Characteristics of dystonia include:
- Repetitive and sustained movements
- Awkward postures
- Movements that are rapid or slow and are often painful
- Involuntary movements triggered by attempts at controlled movement
- Involuntary movements occur more frequently when the person is tired, anxious, tense or emotional
- Pain may also result in an increase in these movements
What part of the body is effected?
Dystonia can be present in only one part of the body, known as focal dystonia, or throughout the whole body, known as generalised dystonia.
Focal dystonia may only occur during a particular movement or task. For example, dystonia in the foot muscles may affect how a person stands on that foot.
Cervical dystonia is another example of a focal dystonia – this is dystonia in the neck muscles which causes the neck to twist, tilt or rotate.
Hemidystonia is where on arm and one leg on the same side of the body are affected by dystonia.
Generalised dystonia refers to dystonic movement that affects both legs and at least one arm, or the trunk in combination with at least one arm or leg. Generalised dystonia can affect mobility as well as cause speech and swallowing difficulties.
Some people with dystonia notice that specific sensations and movements, known as ‘sensory tricks’, temporarily suppress their unwanted movements.
Examples of sensory tricks include:
- Touching the face or chin with a hand or finger
- Resting the back of the head against a wall
- Tucking the hand under the chin
- Placing the hand behind the back
- Some people use these sensory tricks to dampen an unwanted movement in order to prepare their body to make a desired movement.
People with cerebral palsy can also have a range of related conditions or problems, including:
- repeated seizures or fits (epilepsy)
- drooling and swallowing difficulties (dysphagia)
- gasto-oesophageal reflux disease (GORD)
- skeletal abnormalities, particularly hip dislocation or an abnormally curved spine (scoliosis)
- difficulty controlling their bladder (urinary incontinence)
- difficulties speaking (dysarthria)
- visual impairment
- hearing loss
- learning difficulties (although intelligence is often unaffected)
When to seek medical advice
If you are concerned about your child’s development, see your GP. If necessary, they can refer you to a paediatrician (a doctor who specialises in the treatment of children), who can help identify the problem.