Classification

There are several different classifications of CP. The three most predominant types are pyramidal, extrapyramidal, and mixed-type. The type of CP and the degree of involvement play an important part in nutritional assessment and treatment.

Pyramidal (spastic) cerebral palsy Children with spastic CP have increased muscle tone with a clasped-knife quality. In spastic quadriplegia (30% of cases of pyramidal CP), all four extremities are involved. In spastic diplegia (25%), both lower extremities are spastic with minimal upper extremity involvement. Hemiplegia (45%) implies involvement on only one side of the body, with the upper extremity usually more affected than the lower extremity.

Extrapyramidal cerebral palsy Choreoathetosis involves the presence of abrupt, involuntary movements of the upper and lower extremities. This condition can greatly increase energy expenditure and is further discussed in the energy needs section.

Mixed-type cerebral palsy Mixed-type CP includes characteristics of both the pyramidal and the extrapyramidal types. For example, a child may have rigidity in the upper extremities and spasticity in the lower extremities.

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