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Did Your Newborn Suffer Cerebral
Palsy or Another Brain Injury Before
or During Labor and Delivery?

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Our Birth Brain Injury Resource Guide

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Get a FREE guide of resources available throughout Ohio to children and families of children who were born with brain injuries.

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Physical Symptoms of Hypoxic-Ischemic Encephalopathy

Cerebral Palsy Types
Acute, moderate, almost complete Hypoxic Ischemic Encephalopathy (HIE) results in damage to the basal ganglia and thalami and results in athenoid or dystonic cerebral palsy with either intact or mild cognitive deficits. This is also known as athetoid cerebral palsy or dyskinetic cerebral palsy (ADCP). ADCP can exhibit both hypertonia and hypotonia due to the inability to control muscle tone.

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The initial diagnosis of ADCP is usually made before 18 months of birth. MRI and motor function are evaluated before the diagnosis is made. The MRI is accurate in diagnosing 54.5% of those with ADCP, and periventricular leukomalacia is often a common finding. These children require physical therapy and speech therapy.

Athetoid dyskinetic cerebral palsy is a non-spastic form of cerebral palsy. There are two types of nonspastic cerebral palsy, ataxic and dyskinetic. The dyskinetic type consists of two subtypes known as choreoathetoid and dystonic. The first type results in involuntary movements of the face and both extremities while dystonic types of ADCP exhibits slow movements and contractures that may involve the whole body or regions of the body. These can be diplegic, hemiplegic, or quadriplegic which represent bilateral involvement, unilateral involvement, or bilateral with arms usually worse than legs, respectively.

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Chorea may occur which are rapid and repetitive, uncontrolled movements. These uncontrollable movements are not present during sleep but can worsen with stress. The face is affected and can result in grimaces and drooling. Dysarthria is the inability to articulate words properly making speech and eating difficult. They cannot maintain an upright posture and balance is impaired which makes walking and standing difficult. Vision and hearing can be affected. Eye movements may be rapid and out of control which may present with squinting as the first sign.

The second type of damage to the brain from HIE occurs if there is acute, severe or prolonged damage to the cerebral cortex in addition to damage to the thalami and basal ganglia as in ADCP. Along with variable cognitive deficits, this severe form of disability causes a severe and spastic quadriplegia, a small head, and visual disturbances.

Damage to the watershed regions of the brain, if partial, prolonged, and moderate can result in a moderate spastic cerebral palsy with quadriplegia and variable cognitive deficits. If this insult is severe enough, it can extensively affect the cortical region; the result is a severe spastic quadriplegia with severe cognitive problems, vision impairment, and small head.

There are eight clinical signs of cerebral palsy that may be caused by HIE. They are abnormal muscle tone, uncoordinated movement, persistent fetal reflexes, asymmetric posture, balance control issues, fine motor skills, gross motor skills like walking, and vocal or oral dysfunction which impairs speech or swallowing.