Athetoid Cerebral Palsy

What is athetoid cerebral palsy?

Athetoid cerebral palsy is a movement condition that causes involuntary and uncontrollable muscle movements (dyskinesia). It’s the second most common type of cerebral palsy. Cerebral palsy is a neurological condition, or a condition that affects your brain and nerves. It leads to problems with movement and coordination.

Athetoid cerebral palsy affects your child’s movement more severely than other types. As a result, it may lead to a shortened life expectancy.

You may hear your child’s healthcare provider refer to athetoid cerebral palsy as dyskinetic cerebral palsy.

How common is athetoid cerebral palsy?

Around the world, an estimated 1 to 4 out of every 1,000 children receive a cerebral palsy diagnosis. Approximately 12% to 14% of people diagnosed with cerebral palsy have athetoid cerebral palsy. This equals about 1 to 3 people diagnosed with cerebral palsy per every 10,000.

What are the symptoms of athetoid cerebral palsy?

Symptoms of athetoid cerebral palsy include involuntary movements, like:

• Twisting and turning.
• Squirming or writhing.
• Twitching or sudden jerks.
• Repeated motions.

These movements can cause the following:

• Pain.
• Poor posture.
• Drooling.
• A lack of coordination.

What are the signs of athetoid cerebral palsy?

Signs of athetoid cerebral palsy in children may include:

• Repeatedly bending and stretching their arms and legs when lying on their back.
• Delayed developmental milestones (like walking or crawling).
• Frequently twisting and turning, especially turning their head.

What are athetoid-like movements?

The medical terms for the patterns of involuntary athetoid movements are:

• Dystonia: Twisting movements.
• Chorea: Dance-like, fast and repetitive motions.
• Athetosis: Slow, writhing movements.

What causes athetoid cerebral palsy?

A brain injury that affects the basal ganglia and thalamus region (deep within the middle of your child’s brain) causes athetoid cerebral palsy. The basal ganglia is responsible for transmitting messages from the part of your child’s brain that regulates movement and the spinal cord.

An injury to this area can happen during pregnancy, birth or shortly after birth if the following occurred to your baby:

• Hemorrhage.
• Stroke.
• A lack of blood or oxygen to the brain (perinatal asphyxia).
• Too much bilirubin in the blood (hyperbilirubinemia, kernicterus).

What are the risk factors for athetoid cerebral palsy?

A birthing parent may be more at risk of having a child with cerebral palsy if they experienced:

• Pregnancy complications (like uterine rupture).
• Multiples in the uterus (twins, triplets).
• Infertility treatments.
• Chemical exposure (like methylmercury found in seafood).

A baby who experiences the following is more at risk of developing athetoid cerebral palsy:

• Low birth weight.
• Jaundice.
• An infection (like cytomegalovirus, or CMV).

What are the complications of athetoid cerebral palsy?

Complications of athetoid cerebral palsy may include:

• Problems with cognitive development (intellectual disability).
• Epilepsy.
• Speech and language difficulties.
• Hearing or vision loss.
• Orthopedic (bone) malformations, or conditions that affect your child’s musculoskeletal system.
• Sleep disorders.
• Mental health conditions like depression.
• Weighing less than expected for their size and age.
• Aspiration (respiratory failure).

Some of these complications can be life-threatening.

How is athetoid cerebral palsy diagnosed?

A healthcare provider will diagnose cerebral palsy during childhood. It happens after a physical exam and testing. Your child’s provider may ask you (their caregiver) questions about the signs you noticed, the symptoms your child experiences and whether your child is meeting developmental milestones for their age. They’ll also review your child’s motor skills and coordination during the physical.

What tests diagnose athetoid cerebral palsy?

Imaging tests, like a magnetic resonance imaging (MRI) test, look for areas of damage in the brain. Blood tests can help your child’s provider rule out conditions with similar symptoms.

How is athetoid cerebral palsy treated?

Treatment for athetoid cerebral palsy focuses on reducing your child’s symptoms to improve their quality of life. This could include:

• Physical, occupational and/or speech therapy.
• Braces or assistive devices (like a wheelchair).
• Changing your child’s diet to get enough nutrition.
• Medications.
• Botulinum toxin injections.
• Deep brain stimulation (DBS).
• Intrathecal baclofen therapy (IBT).
• Surgery.

A healthcare provider will let you know what treatment options are best for your child so you can make an informed decision about their health. Managing the condition is lifelong since there’s no cure.

What medications treat athetoid cerebral palsy?

Common medications to treat athetoid cerebral palsy include but aren’t limited to the following:

• Baclofen.
• Trihexyphenidyl.
• Levodopa.
• Diazepam.
• Tetrabenazine.
• Carbamazepine.

Are there side effects of the treatment?

Each treatment comes with possible side effects. Your child’s healthcare provider will explain these side effects before they begin treatment. Common side effects of athetoid cerebral palsy medications include:

• Worsening symptoms.
• Drowsiness.
• Headache.
• Muscle weakness.
• Nausea.

Can athetoid cerebral palsy be prevented?

There’s no known way to prevent all cases of athetoid cerebral palsy. You can reduce your risk of having a child with cerebral palsy by visiting your healthcare provider or pregnancy care provider for routine checkups during pregnancy. They can give you advice on how to keep yourself and the fetus healthy and safe.

What can I expect if I have a child with athetoid cerebral palsy?

There’s no cure for athetoid cerebral palsy. It’s a lifelong condition that doesn’t get worse as your child get older (nonprogressive).

Involuntary movements are usually more severe than other types of cerebral palsy. This can impact how your child navigates or completes tasks in their daily routine like brushing their hair or getting dressed. Treatment for athetoid cerebral palsy is available to help your child manage their symptoms and live comfortably.

Children with athetoid cerebral palsy may be underweight due to involuntary muscle movements burning more energy than they’re able to consume. Your child’s healthcare provider will monitor your child’s weight and feeding habits to make sure they get enough nutrition.

What’s the life expectancy for athetoid cerebral palsy?

Your child’s life expectancy varies based on how the condition affects them. The severity is different for each person. Severe symptoms and complications can cause a shortened life. A person’s lifespan is usually shorter with athetoid cerebral palsy in comparison to other types, like spastic cerebral palsy.

When should I see a healthcare provider?

Visit a healthcare provider if you notice signs of athetoid cerebral palsy in your child like delayed developmental milestones or abnormal body movements.

If you have cerebral palsy and experience new or worsening symptoms or side effects from treatment, talk to your healthcare provider right away.

What questions should I ask my healthcare provider?

• What type of treatment do you recommend for my child?
• Are there side effects of the treatment?
• Do I need to change what my child eats so they get adequate nutrition?
• How severe are my child’s symptoms?
• What complications should I look out for?
• What assistive devices will help my child?

A note from Cleveland Clinic

It can be difficult to learn that your child has a lifelong condition without a cure. Athetoid cerebral palsy can make them feel like a fish out of water. Since their brain has trouble sending messages to the part of their body that regulates movement, they may twist and wriggle involuntarily. This type of cerebral palsy causes challenges that may prevent your child from accomplishing their daily routine or navigating the world without an assistive device like a wheelchair. With support from your child’s care team, they can help manage your child’s symptoms so they feel better.