Cerebral palsy is an umbrella-like term that describes chronic non-progressive disorders impairing control of movement that first appear as an infant. Cerebral palsy generally does not get worse over time.
Ataxic cerebral palsy is a particular form of CP that is characterized by lack of control and coordination of the muscles in the arms and legs, particularly with fine motor coordination. It is often marked both by hypotonic muscles and poor coordination and balance. So with ataxic cerebral palsy, there is less of an issue with weakness and more of a concern with incoordination and loss of balance.
As a result, patients with the ataxic cerebral palsy sometimes ambulate with jerking movements and a wide-based gait. These patients may also suffer from tremors that can complicate the performance of daily activities that require fine motor function. Ataxic CP may also cause loss of oral control that results in difficulties with speech and with chewing and swallowing.
Ataxic cerebral palsy is the least common form of CP. Only about 5-10% of all cerebral palsy cases are diagnosed as ataxic CP.
What Are the Symptoms of Ataxic Cerebral Palsy?
One of the primary characteristics of ataxic cerebral palsy is extremely low muscle tone (hypotonia) and lack of control. The hypotonia is most pronounced in early infancy. A baby with ataxic CP will often appear immobile or floppy - like a rag doll. Babies suffering from ataxic cerebral palsy tend to develop slowly and will consistently fall short of normal pediatric development milestones. Muscle tone will gradually increase as the baby grows but it never reaches normal levels. As the child gets old, ataxic CP can significantly affect body movements involving coordination, balance and depth perception. For instance, a child with ataxic CP may overreach when attempting to touch objects that are close up. Ataxic CP also results in lack of hand control making it extremely difficult to perform things such as writing, using scissors, zipping up a coat, tying shoes or buttoning a shirt.What Causes Ataxic Cerebral Palsy?
Ataxic cerebral palsy is caused by damage to the brain cells during childbirth or pregnancy. Like all cells in the body, brain cells require a constant flow of oxygen and blood. Even a short-term interruption of oxygen and blood flow to the brain during pregnancy or childbirth can result in damage and decay to brain cells. It this damage to the delicate cells of the brain that eventually causes ataxic cerebral palsy. There are a number of well-known events during labor and delivery that can potentially cause cerebral palsy:
The core symptoms of ataxic cerebral palsy are uncontrolled or uncoordinated movements. In fact, the word "ataxia" literally means incoordination or lack of order and control. The movements of a child with ataxic CP will often appear disorganized, imprecise or sometimes jerky. This lack of control caused by ataxic CP is most noticeable when attempting to perform certain voluntary, coordinated movements such as picking things up or walking fast. The most apparent symptoms of ataxic CP are:
- Lack of coordination with both fine motor skills (e.g. writing) and gross motor (walking)
- Extremely poor body balance (most noticeable when walking)
- An absence of depth perception (most noticeable when reaching for objects)
- Shakiness and tremors
Earlier, developmental symptoms or signs of ataxic CP can include: walking with a wide gait (feet spread apart); difficulty grasping and picking up objects; unable to bring hands together normally; slow eye movements; and speech issues.Is Ataxic Cerebral Palsy Hereditary?
No. Ataxic cerebral palsy is caused by damage to brain cells during developmental stages. This most often occurs during childbirth or late pregnancy.Is There a Cure for Ataxic Cerebral Palsy?
Unfortunately, there is no actual "cure" for ataxic cerebral palsy. Once the developing cells in the brain are damaged during pregnancy or childbirth, they cannot be repaired or regenerated. Proper management and treatment can make the symptoms of ataxic CP more manageable.How Many Children are Affected by Ataxic Cerebral Palsy?
For every 1,000 babies born in the United States, at least 3 will be diagnosed with some type of cerebral palsy by the time they are 18-24 months old. Just under a million people in the U.S. live with cerebral palsy according to the United Cerebral Palsy Association. Ataxic cerebral palsy is the least common type of CP. Less than 10% of cerebral palsy cases are classified as ataxic CP. More common forms of cerebral palsy are dyskinetic and, the most common, spastic.How Is Ataxic Cerebral Palsy Diagnosed?
The damage to the cerebellum area of the brain the causes ataxic CP generally occurs during labor and delivery or pregnancy. However, an actual diagnosis of ataxic CP is not made right away. In fact, a formal diagnosis of ataxic cerebral palsy is typically made much farther down the road after the child falls short of certain developmental milestones.What Are the Treatment Options for Ataxic Cerebral Palsy?
Treatment for ataxic CP focuses on management of the symptoms and increasing functionality. Treatment plans for ataxic cerebral palsy typically involve a combination of two things: (1) medication; and (2) therapy.
Medication: there are a number of drugs used to help manage the symptoms of ataxic CP. Anti-anxiety drugs are sometimes used to control the tremors and shakes experienced by children with ataxic CP. Other drug combinations are also used to address muscle control issues.
Therapy: intensive physical therapy is the primary method of treatment for ataxic CP. Physical therapy can be effective in increasing muscle and body control and helping children with ataxic CP become more mobile and independent. Occupational therapy provides a more focused approach and aims at increasing practical functionality.
- Get more information on the treatment of CP and the great things that are being done today to improve the lives of CP victims
As we talked about above, ataxic cerebral palsy creates muscle imbalance. This imbalance is doing to lead varying amounts of pressure on different parts of the person's feet that can leads to complications.
One complication is equinus foot deformity. One option to treat equinus foot deformity is orthotics. Another is splinting. Surgery may also be an option to length the tendons.
Other deformities of the feet you often see in children that suffer from CP include varus, valgus, and metatarsal deformities.
The case summaries below are from reported settlements and verdicts in which the primary injury was ataxic cerebral palsy. Why are there so few cases? The settlement and verdict reports do not include the specific type of cerebral palsy.
All cases are unique and these are offered for informational purposes only. In other words, you can't predict the exact settlement value of your child's claim by seeing a case that looks on its face to be the exact same case. Why? There are too many variables that cannot be included in these short summaries. But you also cannot avoid the obvious. Serious injury ataxic cerebral palsy cases can lead to huge settlements and verdicts.
Blunt v. Sierra Vista Regional Medical (California 2013) $74.5 million: Mother alleged that she was allowed to push for hours during labor. Despite clear signs of fetal distress, she alleged that the doctors and hospital staff made no efforts to intervene and aid the delivery. No episiotomy was performed and no effort at forceps or vacuum extraction was made. When the baby was eventually born she had significant brain damage and was eventually diagnosed with severe ataxic cerebral palsy - requiring 24-hour medical care for the remainder of her life. The doctors and hospital insisted that there were no obvious signs of fetal distress and, therefore, no reason to hasten the vaginal delivery or perform an emergency c-section. After a 2 month trial in San Luis Obispo County, the jury awarded the plaintiffs a staggering $74.5 million in damages.
Plaintiff v. Defendant (Michigan 2011) $3.9 million: Mother went to the hospital for scheduled induced labor. The fetal monitor showed everything was fine but it was noted that the baby was positioned face first - a situation that often calls for a C-section delivery. The baby was delivered vaginally and suffered hypoxic ischemic encephalopathy during delivery. The baby was eventually diagnosed with ataxic cerebral palsy. The mother alleged that the hospital staff did not properly set up the fetal monitor and, as a result, it was giving readings of the mother's heart rate instead of the fetal heart rate so the doctors were basically obvious to the fetal distress. Defendants denied liability and causation. One of the primary defenses was that HIE is known to cause other types of cerebral palsy - but that it is not considered to be a cause of ataxic cerebral palsy. The case went to pre-trial mediation which resulted in a settlement for $3.9 million from the hospital and doctor.
Coleman v. United States (Illinois 2003) $19.2 million: Plaintiff had a normal pregnancy but encountered difficulties 6 hours into her labor and delivery. At that point, the doctor allegedly attempted to a vacuum extractor 15 separate times before eventually performing an emergency c-section. The baby allegedly suffered severe ataxic encephalopathy and was diagnosed with cerebral palsy. Plaintiff accused the defendants of breaching the standard of care by overusing the vacuum extractor and failing to perform a timely c-section. The defendants denied that the vacuum extractor was used 15 times and claimed that the baby's injuries were the result of a maternal infection and not trauma during childbirth. A federal court jury in Chicago found in favor of the plaintiff and awarded $19.2 million
When a child is diagnosed with ataxic cerebral palsy, it is very possible that their condition may have been caused by a medical error or negligence during childbirth. Miller Zois has a team of experienced birth injury attorneys with the knowledge and experience necessary to evaluate your case and determine whether or not you have a malpractice claim. Miller & Zois has consistently delivered results for birth injury clients. Call us at 800-553-8082 or click here for a free online consultation.