Spastic diplegia is a form of cerebral palsy that affects muscle control in both legs and arms. Forms of cerebral palsy are caused by developmental problems or injury as a result of trauma, hypoxia or infection to parts of the brain responsible for motor control. When the neural pathways that normally carry messages from the brain to the muscles are damaged or malformed, muscle control is impaired or paralyzed. In the case of spastic diplegia, the complimentary muscles of the legs are stimulated simultaneously rather than in compliment, causing the legs to stiffen instead of bending. Muscle stiffness and weakness in individuals with diplegia can be found in the hips, legs, knees, ankles, feet, and in some cases, the hands, but with less severity than in other forms of cerebral palsy.
More than 90 percent of cases of cerebral palsy, including diplegia, are caused by factors that happen before birth. The remaining cases are attributed to brain injury, hypoxia or brain infections, such as meningitis, that occur either during or after birth. Babies born prematurely or with a low birth weight are at a higher risk for diplegia. Although fetuses and newborns can be affected by periventricular leukomalacia (cysts or lesions in the brain near the central brain artery that cause white matter death), the risk to premature infants is much higher because of additional complications from being born without a fully developed physiology. In infants afflicted by periventricular leukomalacia, nearly all will develop some form of cerebral palsy.
Most children with a form of cerebral palsy show early signs of the disorder by the age of 3. From 70 to 80 percent of children with cerebral palsy have spastic diplegia. Though diplegia is considered to be one of the less severe forms of cerebral palsy, symptoms include muscle coordination problems, delayed attainment of milestones for rolling over, sitting, crawling, smiling and walking. Infants with diplegia present with stiff muscles or decreased muscle tone and exaggerated reflexes. Individuals with diplegia often walk on the toes or with a “scissors” gait. Severity as well as the number of symptoms depends on which specific areas of the brain are affected and to what degree.
There is no cure for diplegia, but it is not a progressive condition — it does not worsen over time. Early diagnosis is important in beginning a course of treatment that will lead to improved quality of life. When cerebral palsy is suspected in an infant, a doctor will make an assessment of the child’s physical and motor development and test the child’s motor abilities. An MRI scan can help a physician pinpoint damage in the brain, if there is any, and help to determine whether to diagnose the condition as cerebral palsy.
The prevailing treatment for spastic diplegia is physical therapy. Early intervention physical therapy provides children the best chance of learning how to perform the greatest range of motor functions and achieve the greatest range of development despite their disability. In addition, orthotic devices, medications, surgery, speech and language therapy, and assistive speech or mobility equipment may be included in the management of the condition.
The most common complications of diplegia are hip dislocation, degenerative or osteoarthritis, scoliosis, and pain due to abnormal musculature and bones. The stress of living with a physical disability can cause depression and other emotional disturbances in addition to premature ageing of the physical body.
If your child suffers from diplegia, you should gather the medical records of both the mother and the child and have them evaluated by an attorney with experience handling medical negligence cases involving children suffering from diplegia as well as other damages or injuries to the brain.