Dyskinetic cerebral palsy (CP) is described as movements that are made by the whole body, or parts of it, and not done with purpose. This includes dystonia, athetosis, and chorea. About 10 to 20 percent have this type of cerebral palsy. These random movements are seen more when the person starts to move. Dyskinetic movements often are seen with spasticity which is called mixed cerebral palsy.

Dyskinetic Cerebral PalsyDyskinetic cerebral palsy is from injury to the basal ganglia of the brain. This area of the brain can be described as the switchboard for taking information to and from the movement center, and the spinal cord. The basal ganglia are in charge of purposeful movements. The different forms of dyskinesia are from injury to slightly different areas in the basal ganglia.

This type of cerebral palsy is typically not linked with preterm birth problems.

Dyskinetic Cerebral Palsy: Types of Movement Disorders

  • Dystonia– Symptoms of dystonia can be twisting and movements that repeat over and over. Dystonia can be in one part of the body, known as focal dystonia, or the whole body, known as generalized dystonia.
  • Athetosis– People with athetosis have changes in muscle tone, changing between being floppy (hypotonia) and extreme random motion (hyperkinesias).
  • Chorea– Identified by movements made that are not with purpose, that are quick, abrupt, without a pattern and not predictable. Those with mild chorea might look fidgety or clumsy. Those with a more severe type of chorea, choreiform, make movements that can be wild and violent, that are large in magnitude (ballism). Chorea can affect many body parts and cause issues with movement, speech and swallowing.>Choreiform movements slow down during sleep. Can be found with athetosis, called choreoathetosis, and may occur with dystonia.
  • Ataxic Cerebral Palsy– About 5 to 10 percent of those with cerebral palsy have the ataxic form. Ataxic CP is caused by damage to the balance centers of the brain, causing random movements made without purpose, affecting balance, depth perception, and coordination.. A diagnosis of ataxic CP is made when all of the other forms are ruled out. Patients can have congenital (from birth) hypotonia, or restricted growth and learning difficulties, with motor milestones and language skills commonly being delayed.There can be tremors, or shakiness, that happens with purposeful movements. People with a diagnosis of Ataxic CP were born at term.

Dyskinesia Treatment Options

A baclofen pump (as discussed in the spasticity treatment section) may be considered by medical team members for the treatment of secondary dystonia, or dystonia due to CP, particularly after medications have been tried. It is not FDA approved yet for this indication (but has been for spasticity). Discuss potential side effects, risks, “off-label” use, and appropriate candidacy with your medical team.

What is Deep Brain Stimulation (DBS)?

DBS delivers electrical impulses (beats of electric sent out), through electrodes implanted (put in) within targeted areas of the brain. It has been used to treat neurological conditions such as essential tremor, Parkinson’s, and certain forms of dystonia, particularly genetic forms. Deep brain stimulation is being explored as a potential treatment for dyskinetic cerebral palsy, but more research is needed, particularly for use in children. Since there are very limited treatment options available for dystonia due to CP, we chose to highlight DBS here for you to discuss developments in research with your medical team. Discuss potential side effects, risks, and appropriate candidacy with your medical team.

Medications (Oral)

Some medications that you may hear about as a potential treatment of dystonia in CP are trihexyphenidyl (Artane), L-dopa or carbidopa-levodopa (Sinemet), clonazepam (Klonopin). Research in other populations have shown tetrabenazine (Xenazine) and zolpidem (Ambien) to be effective in treating some forms of dystonia. Discuss potential side effects, risks, “off-label” use and appropriate candidacy with your medical team.

Chorea Treatment Options

Medications (Oral)

Tetrabenazine (Xenazine) is FDA approved to treat Chorea associated with Huntington’s disease but has not been specifically studied in people who have chorea due to cerebral palsy. Discuss potential side effects, risks, “off-label” use and appropriate candidacy with your medical team.

Athetosis Treatment Options

No effective and widely used treatments known at this time.

Ataxia Treatment Options

No effective and widely used treatments known at this time.

 

For more information, download our free cerebral palsy tool kit.