Types and Classifications of Cerebral Palsy
Cerebral palsy can be notoriously difficult to categorize due to the condition’s wide range of physical impairments, but is generally by classified using up to four determining factors:
Using these determinations, you can more-accurately specify the child’s diagnosis in order to provide a concise “classification” of cerebral palsy (e.g. mild spastic cerebral palsy, severe athetoid hemiplegia, etc). Additionally, the following two classifications are also used to determine levels of disability in regard to cerebral palsy.
By Motor Function
While there are many ways to classify cerebral palsy, in the broadest sense, there are really four major types: spastic, athetoid, ataxic, and mixed.
By Body Distribution
Cerebral palsy often affects certain limbs or areas of the body more than others. Some children may have impairment in only one limb (monoparesis or monoplegia), some may have impairment in both legs (diparesis or diplegia), while others may be more-impaired on one side of the body than the other (hemiparesis or hemiplegia).
In addition to the more-common body distribution classifications mentioned above, some children fall into more-specific categories, such as:
- Triplegia/ triparesis (three limbs affected)
- Double hemiplegia/ double hemiparesis (all limbs affected, one side more than the other)
- Tetraplegia/ tetraparesis (all limbs involved, three more than the other)
- Pentaplegia/ pentaparesis (all limbs affected, as well as head or neck paralysis).
In broadest terms, cerebral palsy can be classified as either mild, moderate, or severe. This level of classification only deals with the general scope of impairment, and is usually used in combination with other classifications (e.g. severe athetoid quadriparesis).
By Muscle Tone
Cerebral palsy is most-often categorized by either increased muscle tone (spastic and/or hypertonic) or decreased muscle tone (non-spastic and/or hypotonic). While not always used when classifying cerebral palsy, these two terms can be used to describe how CP affects a child’s muscle tone.
Gross Motor Function Classification
The Gross Motor Function Classification System (GMFCS) looks at movements such as sitting, walking and the use of mobility devices in order to categorize the level of disability they may face. When evaluating children under two years old, infants are evaluated according to the following:
International Statistical Classification
The International Statistical Classification system (ICD) is the international standard for reporting diseases and health conditions, and is the standard diagnostic tool for epidemiology, health management and clinical purposes. In September of 2015, the ICD-9 system was discontinued in favor of the revised ICD-10 system.
ICD-10 Codes Related to Cerebral Palsy
- ICD-10-CM G80 – Cerebral palsy
- ICD-10-CM G80.0 – Spastic quadriplegic cerebral palsy
- ICD-10-CM G80.1 – Spastic diplegic cerebral palsy
- ICD-10-CM G80.2 – Spastic hemiplegic cerebral palsy
- ICD-10-CM G80.3 – Dyskinetic cerebral palsy (Athetoid/Dystonic)
- ICD-10-CM G80.4 – Ataxic cerebral palsy
- ICD-10-CM G80.8 – Other cerebral palsy
- ICD-10-CM G80.9 – Cerebral palsy (unspecified)
- ICD-10-CM G81 – Hemiplegia
- ICD-10-CM G81.0 – Flaccid hemiplegia
- ICD-10-CM G81.1 – Spastic hemiplegia
- ICD-10-CM G81.9 – Hemiplegia (unspecified)
- ICD-10-CM G82 – Paraplegia and tetraplegia
- ICD-10-CM G82.0 – Flaccid paraplegia
- ICD-10-CM G82.1 – Spastic paraplegia
- ICD-10-CM G82.2 – Paraplegia (unspecified)
- ICD-10-CM G82.3 – Flaccid tetraplegia
- ICD-10-CM G82.4 – Spastic tetraplegia
- ICD-10-CM G82.5 – Tetraplegia (unspecified)
- ICD-10-CM G83 – Other paralytic syndromes
- ICD-10-CM G83.0 – Diplegia of upper limbs
- ICD-10-CM G83.1 – Monoplegia of lower limb
- ICD-10-CM G83.2 – Monoplegia of upper limb
- ICD-10-CM G83.3 – Monoplegia (unspecified)
- ICD-10-CM G83.4 – Cauda equina syndrome
- ICD-10-CM G83.5 – Locked-in syndrome
- ICD-10-CM G83.8 – Other specified paralytic syndromes
- ICD-10-CM G83.9 – Paralytic syndrome (unspecified)
ICD-9 Codes (no longer used)
- ICD-9 343.0 – Congenital Diplegia
Congenital diplegia is a form of cerebral palsy which affects both sides of a person’s body. The term congenital means that the condition is usually present from birth or shortly after childbirth. Also known as congenital diplegia disorder, this condition may manifest itself with the lack of sensation and movement of a child’s arms or legs on either side. This lack of movement may also be due to paralysis and damage to a part of the brain which controls motor function.
- ICD-9 343.1 – Congenital Hemiplegia
Congenital hemiplegia, on the other hand is a cerebral palsy variation which affects only one side of the body. This means that the child may have sustained some form of trauma on one side of the brain. This trauma may have been inflicted due to improper or forceful delivery techniques, leaving the baby in the birth canal for too long or even a brain infection during the 9 month gestational period.
- ICD-9 343.2 – Congenital Quadriplegia
Congenital quadriplegia manifests itself as total paralysis of the body from the neck downward. A person born with congenital quadriplegia may need active assistance in order to go about their daily duties. This is because they aren’t able to control their body and can only move their head. This condition is usually caused by extensive brain and spinal cord damage. In some cases, quadriplegics may have control of their arms and legs but not their fingers and toes.
- ICD-9 343.3 – Congenial Monoplegia
Congenital monoplegia is a condition which presents itself as paralysis of one extremity. This may include things like one arm or one leg, giving the person some type of control and sensation in his other limbs.
- ICD-9 343.4 – Infantile Hemiplegia
Infantile hemiplegia refers to paralysis of one side of the body due to brain trauma. This condition may be manifested during birth or 6 months later, making it a surprising variation of cerebral palsy due to its sudden onset. More boys than girls are diagnosed with this condition, and it’s said to affect the right side of the body twice as much as the left.
- ICD-9 343.8 – Other Specified Infantile Cerebral Palsy
Other specified infantile cerebral palsy may refer to variations of normal cerebral palsy. Under this umbrella, we may find conditions such as spastic paralysis, ataxic cerebral palsy, hypotonic cerebral palsy and others.
- ICD-9 343.9 – Unspecified Infantile Cerebral Palsy
Unspecified infantile cerebral palsy may refer to other general forms of cerebral palsy which occur before, during or shortly after birth. Variations include infantile brain palsy, atonic cerebral palsy, neuromuscular cerebral palsy, hypotonic cerebral palsy and many more.
As previously mentioned, there is no single agreed-upon classification standard for cerebral palsy. As such, there exist several specific types of cerebral palsy, including: