What Causes Athetoid Cerebral Palsy?

Cerebral palsy (CP) is a group of disorders affecting movement, muscle tone, and posture. It occurs when the developing brain is injured or damaged, often before or shortly after birth. Athetoid cerebral palsy, also called dyskinetic cerebral palsy, is a specific subtype of CP characterized by fluctuating muscle tone and involuntary, writhing movements. Understanding the causes of athetoid CP requires exploring how various factors impact the brain's basal ganglia and cerebellum, which regulate movement.

What Is Athetoid Cerebral Palsy?

Athetoid CP accounts for 10-15 percent of all cerebral palsy cases and is distinct due to its hallmark symptoms of uncontrolled, slow, and twisting movements. These movements typically affect the hands, arms, feet, and legs but can also involve the face and tongue, leading to challenges with speaking, swallowing, and facial expressions. Unlike spastic CP, which involves stiff muscles, athetoid CP presents with fluctuating muscle tone, making it difficult for individuals to maintain steady postures or perform coordinated actions.

The condition arises from damage to specific brain regions:

• Basal Ganglia: Responsible for controlling voluntary movements and regulating muscle tone.
• Cerebellum: Essential for coordination, balance, and precision in movement.

The damage disrupts the brain's ability to transmit accurate signals to the muscles, leading to the characteristic movements of athetoid CP.

What Causes Athetoid Cerebral Palsy?

Athetoid CP can result from various factors that impair brain development or function. These causes are broadly categorized into prenatal, perinatal, and postnatal factors.

Prenatal Factors

The majority of CP cases, including athetoid CP, are caused by events occurring during pregnancy. These factors interfere with normal brain development and can include:

• Hypoxic-Ischemic Encephalopathy (HIE): Reduced oxygen supply to the fetus, either through complications in the placenta or umbilical cord, can damage the developing brain. Prolonged oxygen deprivation affects regions like the basal ganglia, making HIE a significant risk factor for athetoid CP.
• Genetic Mutations or Disorders: Some genetic conditions interfere with brain development, leading to structural abnormalities or dysfunction in movement-related regions. Although CP is not inherited, genetic predispositions can increase susceptibility to brain injuries.
• Maternal Infections: Infections such as rubella, toxoplasmosis, or cytomegalovirus while pregnant can cause inflammation in the fetal brain, leading to permanent damage.
• Exposure to Toxins: Prenatal exposure to harmful substances, including alcohol, drugs, or environmental toxins, can hinder brain development and increase the risk of CP.
• Premature Births: Premature babies (born before 37 weeks) are at a higher risk of intracranial bleeding or oxygen deprivation, both of which can damage the brain and lead to athetoid CP.

Perinatal Factors

The perinatal period (during labor and delivery) is a critical time for the brain's health. Complications in this phase can significantly increase the risk of athetoid CP. Common perinatal causes include:

• Birth Asphyxia: Prolonged or severe oxygen deprivation during childbirth is one of the most significant perinatal risk factors for athetoid CP. Birth asphyxia often damages the basal ganglia, leading to dyskinetic movements.
• Traumatic Birth Injuries: Physical trauma during delivery can cause brain hemorrhages or injuries that result in athetoid CP.
• Neonatal Jaundice (Kernicterus): Severe, untreated jaundice in newborns can lead to kernicterus, a condition where high levels of bilirubin in the blood damage the basal ganglia. Kernicterus is a well-known cause of athetoid CP.
• Infections At Birth: Sepsis or meningitis acquired during delivery can lead to inflammation and brain injury, particularly in regions associated with motor control.

Postnatal Factors

Although most CP cases originate before or during birth, some are caused by postnatal events within the first few years of life. These factors include:

• Head Trauma: Severe injuries, such as those caused by car accidents, falls, or physical abuse, can damage the basal ganglia and cerebellum, leading to athetoid CP.
• Infections: Infections like meningitis or encephalitis in infancy can result in brain inflammation and permanent damage to motor control regions.
• Stroke: Blood clots, hemorrhages, or vascular malformations can lead to strokes in infants, depriving parts of the brain of oxygen and nutrients. Strokes affecting the basal ganglia are particularly associated with athetoid CP.
• Toxic Exposures: Exposure to harmful chemicals or toxins after birth can interfere with brain function and increase the risk of neurological damage.

How Can Medical Malpractice Cause Athetoid Cerebral Palsy?

While many causes of athetoid cerebral palsy are unavoidable, some cases may result from medical malpractice, where healthcare providers fail to uphold the standard of care expected during pregnancy, childbirth, or early neonatal care. Errors in medical judgment or procedural missteps can significantly increase the risk of brain injuries that lead to athetoid CP. Examples include:

Prenatal Negligence

• Failure to Diagnose or Treat Infections: Maternal infections like rubella or toxoplasmosis can lead to fetal brain damage if left untreated. Inadequate monitoring or failure to administer preventive interventions may constitute malpractice.
• Mismanagement of High-Risk Pregnancies: Improper care of pregnancies involving conditions such as preeclampsia, gestational diabetes, or placental abnormalities could increase the likelihood of oxygen deprivation and brain injury.

Perinatal Errors

• Delayed Responses to Fetal Distress: During labor and delivery, signs of fetal distress (e.g., abnormal heart rates) require prompt intervention. Failure to perform timely interventions such as an emergency C-section can result in hypoxic-ischemic encephalopathy (HIE), a major risk factor for athetoid CP.
• Improper Use of Delivery Tools: The improper use of forceps or vacuum extractors can cause traumatic birth injuries, including skull fractures or brain hemorrhages, which are linked to athetoid CP.
• Neglecting Jaundice Management: Severe neonatal jaundice can progress to kernicterus if not treated with phototherapy or exchange transfusions. This condition directly damages the basal ganglia, leading to athetoid CP.

Postnatal Negligence

• Failure To Treat Neonatal Infections: Conditions such as meningitis or sepsis must be diagnosed and treated promptly to prevent brain damage.
• Improper Monitoring After Birth Trauma: Inadequate follow-up care for infants who experience traumatic deliveries or oxygen deprivation increases the likelihood of undetected complications, such as strokes, that can result in athetoid CP.

Finding Legal Help For Athetoid Cerebral Palsy Cases

In some instances, athetoid cerebral palsy results from medical errors or negligence. Families of children affected by the condition may be entitled to financial compensation by holding healthcare providers accountable for their actions.

Ross Feller Casey is a premier law firm with an unparalleled history of success in cerebral palsy-related medical malpractice cases. Our team includes leading physicians who meticulously review medical records to determine whether your child's condition stemmed from preventable mistakes or negligence.

Our cases, including those involving athetoid cerebral palsy, are handled on a contingency fee basis, meaning you will not pay anything unless we secure a financial recovery in your case. Contact Ross Feller Casey today to schedule a free case evaluation with one of our expert cerebral palsy attorneys.