Spastic Quadriplegic Cerebral Palsy

Quadriplegia is a form of cerebral palsy that affects all limbs. Severe diplegia is often mistaken for mild quadriplegia, because there is some overlap between terms and disagreement between what the proper diagnosis is. There are several different kinds of quadriplegia.

Someone with moderate spastic quadriplegia can sit quite well, lift himself into a wheelchair independently, may be able to walk short distances with a walker, and has enough hand function to feed himself. Someone with severe spastic quadriplegia cannot walk, has difficulty sitting, is not able to move to and from a wheelchair independently, and usually isn’t able to feed herself. Many children with quadrepeligia have Athetosis, or making large, uncontrollable movements. The severity of athetosis also affects whether they are able to walk or feed themselves, and some children with severe athetosis have speech problems as well.

Children who are most at risk for severe quadriplegia are those who have had high risk health problems and complications during birth, including prematurity, low birthweight, bleeding in the brain, severe asphyxiation, aspiration (fluid in the lungs), severe meningitis, shaken baby syndrome, and severe jaundice (though Jaundice is now less common). Nutrition is also an important issue. A child who is not growing either is not getting adequate nutrition or is having severe medical problems, and it is likely that the brain is not growing either.

Many children with quadriplegia require a shunt, a surgically implanted device that prevents fluids from building up in the brain. Shunts must be checked frequently for infection.

Children with quadriplegia may have mental retardation, though some may be thought to have mental retardation when in fact they are only limited in their ability to communicate. This can be tested by a properly trained individual.

A quadriplegic child may have oral motor dysfunction which can make chewing and swallowing difficult. This can lead to chronic aspiration and pneumonia. Gastric reflux can be a problem, because coughing while spitting up or vomiting can introduce food particles into the lungs, causing bronchitis and pneumonia. It is often helpful to sit your child up after feeding him. Medications can also help these problems. In the most severe situations, surgical options may be recommended, such as placement of a gastrostomy tube or a fundoplication.

After birth, therapy should not be started until your baby is medically stable. Too much stress on the heart and lungs can cause high blood pressure and can cause further brain damage.
Warning signs, like with other forms of CP, are hard to detect until about the age of 1. By this age, most children are rolling over, sitting, and pulling to a stand, while a child with quadriplegia may not have head control yet. Making sure the child is getting adequate nourishment is important at this age. Another common issue is constipation. This may be an issue if your child seems uncomfortable or irritable.