What to Know About Dyskinetic Cerebral Palsy

Medically Reviewed by Dany Paul Baby, MD on April 27, 2022
7 min read

Dyskinetic cerebral palsy is the second-most-common type of cerebral palsy (CP) in the U.S. All forms of cerebral palsy are life-long conditions that affect muscle movement and control. 

CPs are the most common cause of physical disability in children — developing in as many as 1.5–2.5 children out of every 1,000 births. 

Dyskinetic cerebral palsy is defined by involuntary movements that get worse whenever you intentionally try to move the affected part of your body. 

Like all cerebral palsies, dyskinetic CP occurs due to damage in certain areas of your brain. The damage can form while you’re still in the womb or while your brain is still developing as an infant. 

Dyskinetic cerebral palsy can involve three different types of involuntary movement: 

  • Dystonia — which involves a lot of twisting and repetitive movements
  • Athetosis — which is characterized by slow, continuous movements that persist even when you’re at rest
  • Chorea — derived from the Greek word for dance, the resulting movements are brief, abrupt, and unpredictable

You may have just one of these movement types as your most pronounced symptom, but athetosis and chorea often co-occur — a condition referred to as choreoathetosis.

Cerebral palsies are a group of related disorders that are distinguished by the area of the brain that's affected and the particular ways that your muscles respond to the damage. 

The most common type of CP is spastic cerebral palsy. This version is characterized by stiff muscles and occurs in over 75% of all cases of CP. Comparatively, only 5% to 6% of cases are dyskinetic CP. 

An even less common kind is called ataxic cerebral palsy. People with this version predominantly have problems balancing and walking around. 

It’s also common for people to have multiple versions of CP at the same time. Your predominant symptoms may even change as you grow up from one version of the disorder to another. 

The medical community is still in the process of understanding the exact cause of cerebral palsy. All cases seem to be due to brain lesions or other disturbances that form in very young brains. The damage doesn’t continue to expand throughout your lifetime. 

For dyskinetic CP, the damage is located in a part of your brain called the basal ganglia. This region interprets the messages that are being sent from the movement center of your brain to your spinal cord. When it is working normally, it essentially helps you regulate all of your voluntary movements. It’s also involved in regulating your emotions, mood, and behaviors. 

Potential causes for all types of brain damage related to CP can be divided into prenatal and postnatal categories. Examples of prenatal causes include: 

  • Intrauterine infections
  • Intrauterine stroke
  • Chromosomal abnormalities

Examples of postnatal causes include: 

Two of the greatest risk factors for cerebral palsy are low birth weight and premature birth. Your baby is particularly at risk if they’re born earlier than 28 weeks. Babies with birth weights that are less than about 3.3 pounds have a 5% to 15% chance of developing CP. 

Other risk factors include: 

More research is needed to understand exactly who is most at risk for developing — or possibly passing on — this disorder. 

Although CP is present from a very early age — even before birth — it’s likely going to take a few months to diagnose it. In severe cases, you’ll definitely know that your child has this condition by the age of two. It could take as long as three or four years to notice symptoms in mild cases. 

There isn’t one specific test for CP, but an early indicator is if your baby isn’t reaching developmental milestones at the right ages. Your baby may, for instance, be slow to: 

  • Sit up
  • Crawl
  • Stand
  • Walk

There are also standardized motor assessments that look for particular warning signs like cramped, synchronized movements, a lack of fidgety movements, or uncontrollable eye movements. These assessments are specific to different ages. They should be administered by your doctor at the appropriate developmental time.

If early signs indicate problems, magnetic resonance imaging (MRI) is the most sensitive imaging technique for detecting problems in your brain’s development. Your doctor will look for damage to regions of the brain that are associated with CP.    

While some symptoms are unique to dyskinetic cerebral palsy, others can occur in any version of the condition. Examples include: 

  • Pain — which is present in 50% to 75% of all cases of CP
  • Speech impairment — in 40% to 50% of cases
  • Hearing impairment — in 10% to 20% of cases
  • Orthopedic disorders — such as scoliosis or developmental problems in your feet
  • Growth failure
  • Heart disease

Your mental abilities are less likely to be affected by dyskinetic CP compared to other versions. Only one out of four people with this condition have pronounced alterations to their mental abilities or epilepsy on top of their other symptoms. In some versions of CP, these symptoms are present in 50% of people instead of this 25% rate. 

The three different types of dyskinetic movement often have other characteristics that co-occur more frequently with one movement than another. 

Dystonia. Of the three types, dystonic movements tend to be the most pronounced. Your dystonic movements can either be specific to one body part — called focal dystonia — or affect a greater portion of your body. It’s called generalized dystonia when both of your legs and at least one arm are affected or your trunk and at least one limb. 

For example, focal dystonia may only impact your foot and the involuntary movements become much more pronounced when you try to put weight on it. Generalized dystonia can cause problems with your speech and swallowing abilities. 

Other characteristics of dystonic CP include: 

  • Abnormal postures 
  • Both fast and slow movements
  • Painful movements

Athetosis. These movements involve uncontrollable fluctuations in muscle tone — switching from being limp and floppy in one moment to making an extreme variety of motions in the next. 

Other characteristics of this type of dyskinetic CP include: 

  • A restless appearance — because of the constant motion
  • Grimacing or drooling when facial muscles are affected
  • Difficulty making very specific movements — like scratching your nose
  • The need to fully relax before you can be truly still
  • A decrease — or complete cessation — of involuntary movements when you’re asleep
  • Difficulties holding and manipulating objects — like forks or pens

Chorea. Other characteristics associated with this type of movement include: 

  • Wide, sweeping movements
  • Wild violent motions
  • A decrease in motion when you’re asleep

In general, all dyskinetic movements can also become more pronounced when you’re experiencing stress.  

All versions of cerebral palsy require an interdisciplinary treatment approach. The condition can affect so many different parts of your body and areas of your life that it’s best to consult experts in multiple fields. Your team is likely to include:

  • Physicians
  • Therapists
  • Behavioral specialists
  • Social workers
  • Education specialists

The exact treatments that you need depend on the severity of your symptoms. Examples include: 

  • Physical therapy
  • The use of mobility assisted devices — like walkers or a wheelchair
  • Medications to control pain 
  • Medications that affect your movements — though more research is needed to prove the usefulness of many of these products
  • Surgeries to improve movement in your affected body parts — like your feet, hips, legs, or arms

There are also newer neurological techniques that could be promising for some versions of CP. An example is a technique called deep brain stimulation. Talk to your medical team to discover the availability of cutting-edge treatments for this condition and see if any of them are right for you. 

There is one particular treatment technique that can specifically help with dyskinetic CP. 

Dyskinetic movements are different from other muscle movements involved with CP because they specifically become more pronounced whenever you intentionally attempt to move your affected limb. This can be very frustrating — but there are ways to help manage the movements and your responses to them. 

For example, sensory tricks can be particularly effective for controlling dystonic movements. The basis for this technique is that certain sensations and movements can temporarily suppress unwanted motions. 

Examples of distraction techniques include: 

  • Touching your face with your finger
  • Letting the back of your head rest against the wall
  • Tucking your hand away or placing it behind your back 

People with mild forms of cerebral palsy will survive into adulthood, but people who are severely affected by the disorder have decreased life expectancies. Respiratory diseases — like pneumonia — are the most common cause of early death in people with CP. 

In terms of your movement abilities and other symptoms, the long-term effects will depend on your particular version of CP. In general, people with CP who are able to walk independently will have started by the age of three, and people who will need support have started to walk by, at most, the age of nine. 

People with CP who aren’t yet walking at all by the age of nine may never be able to walk. Still, keep in mind that — regardless of symptom severity — everyone with CP is capable of living a full and vibrant life if they’re given the love and support that they need.