Ataxic cerebral palsy is a 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. Children with ataxic CP will usually suffer from tremors and shakes in the arms and hands along with a general lack of coordination. Fine motor activities such as writing or hand clapping can be particularly difficult. Ataxic CP causes similar lack of control in the lower limbs and children with this form of CP will often have a "wide gait" where the walk with their feet wider that their hips. Some kids with ataxic cerebral palsy may be unable to walk at all. Ataxic CP also causes oral control loss which 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.
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.
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 or 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 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)
- 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.
No. Ataxic cerebral palsy is caused by damage to brain cells during developmental stages. This most often occurs during childbirth or late pregnancy.
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.
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 least common type of CP. Less than 10% of cerebral palsy cases are classified as ataxic CP.
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.
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.
The case summaries below are from reported settlements and verdicts in which the primary injury was ataxic cerebral palsy. All cases are unique and these are offered for informational purposes only.
Blunt v. Sierra Vista Regional Medical (California 2013) $74.5 million: Mother in this case alleged that she was allow 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 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 c-section delivery. The baby was delivery 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 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.