Cerebral palsy (CP) is a lifelong congenital condition that causes palsy, or impaired movements, due to brain damage at a very young age. Spastic quadriplegic cerebral palsy (SQCP) is a severe type that is characterized by paralysis of both arms and both legs, with muscle stiffness.

CP can vary in severity and which parts of the body it affects. Although the damage to the brain involved is not progressive, a person’s symptoms may change and develop over time. Spastic CP is the most common type of CP. People with this condition can have weakness and spasticity in one limb, which has less of an impact on their life than SQCP.

Research estimates that roughly 20% of infants with CP have SQCP. The term “spastic” refers to a type of movement due to increased muscle stiffness, and the term “quadriplegic” refers to paralysis of all four limbs.

This article will explain what SQCP is, including the symptoms, causes, diagnosis, treatment, outlook, and more.

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SQCP is a severe type of CP. Spasticity can vary from mild stiffness to severe pain and uncontrollable muscle spasms. It is possible to have several types of CP. The types have a diagnosis based on the predominant involuntary movements — spastic, dyskinetic, or ataxic.

As the term “quadriplegic” suggests, the condition affects both arms and legs. SQCP may also affect the trunk, including the chest, abdomen, pelvis, and back, as well as the face.

A person with SQCP experiences weakness and spasticity in both arms and both legs. Symptoms may include:

  • tight muscles that do not relax
  • muscles that rapidly contract and then partially relax
  • weakness in both arms and legs, often with weakness in the trunk, back, and neck, as well
  • a flexed position, with an inability to extend the flexed joints
  • difficulty walking
  • limb “scissoring,” which is a crossing of the legs at the knees

Spasticity affecting the arms can lead to difficulty performing day-to-day tasks, such as:

  • eating or drinking
  • washing oneself
  • holding or manipulating objects
  • dressing oneself
  • writing

Spasticity affecting the legs makes it difficult for a person to:

  • walk
  • stand up
  • sit upright
  • change position
  • reposition in bed

People who have SQCP can also have other effects of CP, such as:

If a parent or caregiver has any concerns about their child’s development, it is best they speak with a doctor.

If a person is having difficulty managing their symptoms or helping a loved one with SQCP, they may wish to contact a doctor for support. A person with SQCP may benefit from a range of additional supports involving physical, occupational, and speech therapy.

Changes to the brain that cause SQCP happen early in a person’s life. The damage occurs before, during, or within the first few years after birth. Research shows that doctors will often be able to see signs of severe CP in infants within the first 12 months.

To diagnose SQCP, a doctor may consider an infant’s history, such as any difficulties during childbirth, as well as their growth and development. They will perform a physical exam to assess any delays in an infant’s motor skills and reflexes, or problems with hearing and vision, as well as observe any unusual posture and muscle tone.

Further brain imaging tests, such as CT and MRI scans, can help confirm the diagnosis of SQCP and rule out conditions that may cause similar symptoms.

SQCP occurs due to abnormal development or damage in areas on both sides of the brain that are responsible for movement. For the majority of CP cases, these changes to the brain occur before or during birth.

However, in some cases, the exact cause is unknown. The following factors may increase the risk of developing CP:

In rare cases, some may develop SQCP after birth due to damage to the brain in early life from infections, injury, or reduced oxygen to the brain.

Alongside these risk factors, recent research has shown that genetics may play a much larger role in the development of CP than previously thought. A 2022 paper states that about 10% of CP cases examined were found to have certain genetic patterns, but it is unclear whether these genetic changes were inherited.

There are several treatment options for SQCP that aim to help relieve pain and discomfort, reduce spasticity, reduce complications, such as joint dislocation, and generally improve a person’s quality of life. There is currently no cure for SQCP.

In severe cases, even with treatment, a person may still need support with day-to-day activities such as moving around, eating and drinking, and washing themselves. However, treatments can help with their mobility and comfort, making such care easier and more effective.

Each person with SQCP is different, and with the help of their caregivers and doctors, they can find a combination of treatments that suits them and their specific needs. Common treatment options for CP include:

  • Medications: Medications can help relax overactive muscles and reduce stiffness. They can come in the form of oral pills, injections, or infusions.
  • Surgery: Surgical procedures can lengthen muscles that have become too tight, correct abnormal curves in the spine, or interrupt certain nerves that may be responsible for spastic movements.
  • Assistive devices: Computerized devices can help a person who may otherwise have difficulty with speech communicate their feelings and needs to those around them. Other devices, such as wheelchairs and powered scooters, can help a person’s movement and increase their level of independence.
  • Physical therapy: Physical therapy can involve exercises that help a person improve muscle strength, balance, and movement and help reduce complications.
  • Other therapies: Other therapies that can help improve a person’s quality of life include occupational therapy, recreational therapy, and speech and language therapy.

SQCP is the most severe type of CP, with symptoms involving all four limbs. Other potential symptoms include difficulty swallowing and speaking and problems with vision. This means that a person with SQCP may need lifelong care.

Evidence suggests that a person with more severe mental and physical impairments may be less likely to walk independently, have difficulty with speech, and have a shorter life expectancy. However, this data represents an average of a population and cannot predict the outlook for an individual specifically.

While the symptoms of SQCP can significantly affect a person’s day-to-day life, treatment and support can help give a person with SQCP as much independence as possible, boost their ability to communicate their feelings and needs, and increase their quality of life.

SQCP related to genetics may not be preventable. However, a person can manage risk factors by taking steps to reduce the chance of infection before or during pregnancy.

A 2020 paper found that due to increasing awareness of CP and its risk factors, the number of infants born with CP has dropped by 35% over the previous 15 years.

While some cases may not be preventable, recent research finds that early diagnosis can help optimize neuroplasticity, prevent complications, and increase the caregiver’s well-being.

SQCP is a type of CP that affects all four limbs, which can make it difficult to move around independently and also cause discomfort. A person may also experience other symptoms that greatly affect their day-to-day life, such as difficulty swallowing and speaking, gastrointestinal symptoms, and cognitive impairment.

While the condition is lifelong and does not currently have a cure, there are many treatment and support options to help a person with SQCP have as much independence and agency as possible and allow them to be more comfortable.