Athetoid cerebral palsy: what is it, and how is it treated?

What is Athetoid Cerebral Palsy?

Athetoid cerebral palsy, also known as dyskinetic cerebral palsy, is a type of cerebral palsy characterized by involuntary, repetitive, and twisting movements. It is one of the three most common forms of cerebral palsy, alongside spastic and ataxic types. This condition is more frequently observed in males than females.

Symptoms often appear early, around the age of two, and typically affect most parts of the child’s body.

Patients with athetoid cerebral palsy may experience abnormal movements in any part of the body, resulting in fatigue, stress, pain, and difficulties with actions such as sitting, standing, grasping, and even speaking. Some children may also have trouble hearing or controlling their breathing. However, intellectual development is usually not affected.

This type can be distinguished from spastic cerebral palsy by the muscle tone variation, and from ataxic cerebral palsy through differences in balance and coordination.

How does Athetoid Cerebral Palsy present?

Children with athetoid cerebral palsy often exhibit:

• Slow, writhing or fast, jerky movements in the hands, arms, or feet without a clear goal.
• When intentional movements are attempted, they are often excessively forceful or rapid.
• Poor balance and frequent falls.

The disorder originates from damage to the central nervous system, with symptoms including:

Abnormal muscle tone

One of the most noticeable signs is fluctuating muscle tone, where muscles may become unusually stiff (hypertonia) or excessively weak (hypotonia). This leads to difficulty in controlling movements, resulting in either floppiness or rigidity.

Children may experience limp limbs or stiffness that restricts normal movement. In some cases, actions may be too rapid or too slow, affecting basic daily activities like walking, grasping, or even sitting and standing.

Difficulty with movement control

Athetoid CP causes significant challenges in voluntary motor control. Children often struggle to initiate or regulate purposeful actions. Involuntary movements such as head nodding, finger or toe twitching, or repetitive mouth opening are typical signs. Drooling may occur due to poor control over mouth and tongue muscles.

Poor gross motor skills

Gross motor skills—such as walking, standing, running, and jumping—are typically impaired. Simple tasks like walking steadily or running may become difficult or impossible.

Chorea (involuntary twisting movements)

Chorea is a hallmark symptom of athetoid CP, involving uncontrolled rotating or writhing movements. It results from damage to the extrapyramidal system—a part of the brain that coordinates movement. When impaired, coordination between the extrapyramidal system and cerebellum is disrupted, leading to involuntary motions.

Primitive reflexes

Parents may detect signs of cerebral palsy through persistent primitive reflexes. These reflexes, which appear at birth (e.g., sucking, startle), usually fade as the child develops. In children with athetoid CP, they may persist longer than usual due to damage in brain areas that control automatic reflexes—indicating delayed motor development.

Sensory processing disorders

Children may also suffer from sensory dysregulation, either overreacting to or being indifferent to environmental stimuli. For example, a child may react strongly to being touched or may show no reaction even in dangerous situations.

Seizures and swallowing difficulties

Besides motor challenges, the condition may affect sensory and neurological functions. Children may experience seizures, swallowing disorders, or high-frequency hearing loss.

Risk of paralysis

In severe and prolonged cases, communication between the brain and muscles may be impaired, leading to partial or total paralysis.

Nutritional disorders

Children may experience nutrition-related issues, such as muscle rigidity or enlargement, which hinder movement and basic physical functions, though it does not cause muscle atrophy.

These symptoms can significantly disrupt daily life. Early detection and diagnosis are essential for timely intervention and treatment.

Treatment and Rehabilitation for Athetoid Cerebral Palsy

Common therapies include physical therapy, electrotherapy, hydrotherapy, and communication training. Interventions are tailored to each child’s specific needs, and lifestyle and nutrition must also be adjusted accordingly.

Physical therapy

This focuses on improving gross motor skills and developing progressively complex movement abilities, such as head control, rolling over, sitting, crawling, standing, walking, and running.

Once the basics are mastered, advanced exercises help enhance higher-level motor coordination.

Electrotherapy

Used for children without clinical seizures, this involves low-frequency, stable direct current to aid treatment. Common techniques include Galvanic CaCl₂ application to the neck and back.

Hydrotherapy

Water therapy helps relax muscles and reduce tension, making voluntary movement easier and more controlled. This method is not suitable for children with epilepsy.

Speech and language therapy

Children with athetoid CP need support to develop language and communication skills. Early training helps build relationships, increase independence, and reduce reliance on caregivers.

Therapists and parents should use slow, clear speech and simple sentences. Visual aids, videos, and playful activities help capture attention and improve learning. Encouragement and praise for completed tasks boost motivation.

Early Screening and Prevention

Prenatal screening plays a vital role in preventing health risks. Mothers should consider maternity care programs at reputable medical centers to monitor health throughout pregnancy and delivery, offering peace of mind and early support.

Disclaimer: This content is for informational purposes only and does not replace professional medical consultation, diagnosis, or treatment. Patients should seek care at trusted healthcare facilities and follow the guidance of specialists.

We hope this article has helped you better understand athetoid cerebral palsy. Accurate diagnosis and timely treatment are essential in minimizing the long-term impact on a child’s health and life. For further assistance, please feel free to contact us.