When a child is diagnosed with cerebral palsy, the parents might feel emotionally devastated. It is common for parents to worry about their children’s future and whether they will ever be able to live independent, happy lives. Cerebral palsy (CP ranges in severity and does not affect all children with the condition in the same way. It includes multiple different subtypes that describe the types of symptoms and the areas of the body that are impacted.
Cerebral palsy can be caused by a brain injury before, during, or after a baby’s birth. Out of the main types of cerebral palsy, spastic cerebral palsy is the most common, affecting 80% of all children who are diagnosed with CP.
Spastic cerebral palsy also encompasses several subtypes that derive their names from the areas of the body that are impacted. The primary subtypes include spastic diplegia, spastic hemiplegia, and spastic quadriplegia. Spastic hemiplegia is a type of spastic CP in which the child is primarily affected on only one side of the body. Here is some information from the cerebral palsy lawyers at Raynes & Lawn you should know about spastic cerebral palsy, its causes, symptoms, and treatment, and when you might have a viable malpractice claim against those who might have caused your child’s injuries and resulting condition.
What Is Spastic Cerebral Palsy?
Spastic CP is the most frequently diagnosed type of cerebral palsy. Other main categories of CP include dyskinetic cerebral palsy, ataxic CP, and mixed-type cerebral palsy. All cases of cerebral palsy involve movement disorders resulting from brain damage, and there are multiple subtypes. Spastic CP results from brain damage in specific regions of the brain that are responsible for motor function while the brain is developing during pregnancy, labor, delivery, or shortly following birth.
The subtypes of spastic CP derive their names from the portions of the body that are affected. People who have spastic cerebral palsy might have the following symptoms in the affected bodily areas:
- Muscle rigidity and stiffness
- Trouble moving affected limbs
- Muscle spasticity
- Trouble changing positions in the affected area
- Uncoordinated movements in the affected area
- Difficulty balancing
- When the muscles of the face and tongue are affected, difficulty swallowing and speaking
Spasticity refers to an abnormal increase in muscle stiffness or tone, which can cause pain, trouble moving, or difficulty speaking. It results when regions of the brain that control motor function are damaged. Some of these regions include the pyramidal tracts or the brain’s motor cortex.
What Is Spastic Hemiplegia?
Spastic hemiplegia is a fairly common subtype of spastic CP. In children with spastic hemiplegia, movement on only one side of the body is affected. It results from brain damage during pregnancy or birth on only one side of the regions that control movement and affects the opposite side of the body because of the neural wiring of the brain. In most people, one side or hemisphere of the brain controls the body’s opposite side. For example, if a baby suffers damage to areas responsible for motor functioning on the right side of the brain, the symptoms of spastic hemiplegia will occur on the child’s left side of the body. For example, a child with spastic hemiplegia will experience spasticity, stiff muscles, and other symptoms in the leg and arm on one side of the body but not the other.
Symptoms of Spastic Hemiplegia
Children and adults with spastic hemiplegic cerebral palsy might experience a broad range of symptoms, and not everyone diagnosed with the condition will experience all of the associated problems. Some people are only affected mildly while others have severe symptoms. Some of the most common symptoms of spastic hemiplegia include the following:
- Muscle rigidity and stiffness on one side of the body
- Difficulty performing tasks with the hands, including writing and others that require fine motor movements
- Muscle weakness on one side of the body
- Trouble walking
- Problems balancing
- Difficulty with voluntary movements on the affected side
- Balling hand into a fist on the affected side
- Awkward movements of the hand
- Asymmetrical motor control
- Toe or scissor walking
Some children with spastic hemiplegia might also have intellectual disabilities. Between 11% and 19% of children with spastic hemiplegia have been found to have intellectual quotients (IQs) under 70, which is the threshold for a diagnosis of intellectual disability. Many children with spastic hemiplegia miss developmental milestones, including sitting up, crawling, talking, or walking, and they might not achieve them until later than other children.
Children with spastic hemiplegia might miss the following developmental milestones at the proper ages:
- Lifting and controlling the head – Two months
- Rolling over – Four months
- Sitting up – Six months
- Walking – 12 months
Here is some additional information about some of the common symptoms experienced by children with spastic hemiplegia.
Children who are diagnosed with spastic hemiplegic cerebral palsy have spastic muscles on one side of their body. Spasticity causes the muscles to contract involuntarily and results from brain damage to the motor cortex of the brain. Located in the brain’s cerebral cortex, the primary function of the motor cortex is the control of movement. When one side of it is damaged, the affected child will have trouble with involuntary muscle contractions on the opposite side of the body and difficulty controlling movement. Damage to the motor cortex disrupts the brain’s nerve signals to the muscles on the affected side of the body, causing them to remain involuntarily contracted.
Muscle spasticity can also result in other complications, including an abnormal gait, problems with growth, pain, and others. Spasticity on one side of the body can have a severe impact on mobility if it is not appropriately treated and potentially cause problems with a child’s ability to walk.
Since children with spastic hemiplegia experience symptoms on one side, including having one affected leg and arm, they typically have abnormal gaits. These gaits result from the inability of the child to fully relax the spastic muscles in the affected leg. They will thus experience stiff, jerky movements in the affected leg, making it difficult for the child to balance and walk normally.
Many children with spastic hemiplegia experience a complication that is known as an equinus ankle. In this condition, the spastic muscles in the affected ankle prevent the foot from flexing normally, causing it to draw up in a curled position that results in toe walking. While some toddlers without spastic hemiplegia also walk on their toes, healthy children normally outgrow it by the time they reach age six. Those with spastic hemiplegia don’t outgrow the issue. Without treatment, toe-walking can lead to an even more abnormal gait, displace the joints of the hip, and cause children to lose balance and fall frequently.
Another issue that can lead to an abnormal gait in children with spastic hemiplegic CP is called foot drop. This complication results from the child’s trouble with lifting the foot’s front portion. It can be corrected with treatment so that limb deformities can be prevented.
Muscle Weakness on the Affected Side
When a child suffers severe spasticity on the affected side of the body, they might not get enough physical exercise. Muscle strength depends on daily movements to place pressure on the joints, bones, and muscles. When a child does not get enough regular physical activity, the muscles on the affected side can weaken and atrophy.
Since spastic diplegia is a motor control and movement disorder that affects one side of the body, parents might not recognize that there is something wrong until their children start missing developmental milestones. Spasticity and muscle weakness on the affected side can cause children to fail to reach these milestones on time. Motor delays don’t mean that the children will never reach the developmental milestones, however. They mean that it might take longer for children with spastic hemiplegia to meet them. With proper treatment and time, children with spastic hemiplegia might learn to walk independently. Children with severe spastic hemiplegia might learn to get around independently with the use of mobility devices to increase their independent functioning.
Causes of Spastic Hemiplegic Cerebral Palsy
Spastic hemiplegia is a type of spastic CP that is caused by brain damage to regions of the brain involved with motor control and movement. The damage to the brain typically occurs during pregnancy, labor, delivery, or immediately following the child’s birth. In some cases, the damage is caused by a birth injury that might be caused by the medical negligence of a doctor, midwife, nurse, anesthesiologist, or another healthcare provider. The following medical problems and birth injuries can cause spastic hemiplegia:
- Preterm birth
- Birth of twins or multiples
- Hypoxic-ischemic encephalopathy (HIE)
- Birth asphyxia/hypoxia
- Low Apgar score
- Interruption of the oxygen and blood flow to the fetus
- Maternal or fetal infections
- Fetal stroke
- Breech or another abnormal birth position
- Rh incompatibility
- Traumatic brain injury
Healthcare providers who make medical mistakes before, during, or following birth might cause birth injuries that cause a child to develop spastic hemiplegia. The following types of medical errors can cause birth injuries that lead to spastic hemiplegia and might rise to the level of medical malpractice:
- Failing to properly monitor the mother for infections during pregnancy
- Failing to diagnose and treat maternal infections
- Failing to diagnose and treat an infant’s jaundice following birth
- Improper use of vacuum extractors or forceps during delivery
- Using too much force during delivery
- Failing to properly monitor the fetus during pregnancy or labor to identify signs of fetal distress
- Failing to properly intervene when a fetus is experiencing fetal distress
- Failing to perform an emergency Caesarian section when indicated
- Administering improper doses of labor-inducing drugs
- Failing to properly diagnose umbilical cord issues and intervene appropriately
When a child suffers birth injuries that subsequently result in spastic hemiplegia, the parents might want to consult a cerebral palsy lawyer at Raynes & Lawn to learn about their legal rights and options.
Potential Complications Associated With Spastic Hemiplegia
Multiple complications are associated with spastic hemiplegia, including the following:
- Deformities of the limbs on the affected side
- Equinis ankle and foot drop
- Learning disabilities
- Intellectual disabilities
- Seizure disorders
- Visual impairments
- Hearing impairments
Age of Diagnosis
Children with spastic hemiplegia might not be diagnosed with the condition for months following birth. In some cases, children might be diagnosed when they reach around five months old, but some are not diagnosed until later. When children are around five months old, the fact that they are missing some developmental milestones might be noticed. The parents might then seek their doctor’s advice to learn why their child is not meeting the developmental milestones on time.
Since spastic hemiplegic cerebral palsy ranges in severity, a child with a less severe form of the condition might not be diagnosed until they are 18 months or older. At that time, parents might notice more obvious symptoms such as prolonged toe-walking, scissor walking, and other indicators of the condition.
Treatment for Spastic Hemiplegic CP
While it’s important to note that spastic hemiplegia can’t be cured, early and ongoing treatment can reduce your child’s symptoms and improve their ability to live an independent, fully functional, and happy life. Your child’s prognosis will depend on multiple factors, however, including how severe their condition is.
Following your child’s diagnosis, your child’s doctor will create a tailored treatment plan to address your child’s specific symptoms and issues they experience. Treatment plans for spastic hemiplegia typically include the following types of treatment and intervention:
- Physical therapy to reduce spasticity, increase muscle strength, and improve your child’s gait
- Occupational therapy to help improve fine motor control on the affected side and help your child perform the activities of daily life
- Speech therapy to help improve your child’s speech and ability to swallow food
- Orthotic devices to aid your child’s ability to walk and move
- Nutrition assistance
- Social work to connect your family with community resources
- Medication to manage symptoms, including anti-seizure drugs, muscle relaxers, Botulinum injections in spastic muscles, and others
- Surgery to correct and prevent limb deformities or to relieve severe spasticity
Medical Malpractice and Spastic Hemiplegic Cerebral Palsy
Just because your child has been diagnosed with spastic hemiplegia doesn’t necessarily mean their condition was caused by medical malpractice. In some cases, it won’t be possible to determine the cause of this condition. However, spastic hemiplegia sometimes results because of the negligence of a medical professional around the time of birth. If your child suffered a birth injury because of a healthcare provider’s medical errors that later caused spastic hemiplegia, you might have a viable malpractice case.
Pennsylvania requires plaintiffs in medical malpractice cases to get an expert opinion about what happened before they can file lawsuits. The medical expert will review the medical records to determine the appropriate standard of care and whether the provider(s) in your case delivered substandard treatment that caused your child’s injuries and resulting CP diagnosis.
The standard of care varies based on the geographic location where the provider practices and their medical specialty. For example, an obstetrician in Philadelphia would be compared to other obstetricians in Philadelphia instead of a doctor in a different city.
The standard of care is determined by the type of treatment a reasonably competent medical provider in the area and the same field of practice would have provided under similar conditions. After determining the standard of care, your cerebral palsy lawyer and the expert will then determine whether your provider’s care deviated from it and caused your child’s injuries and resulting diagnosis. If your attorney determines that malpractice likely occurred, they will file a certificate with the court at the time they file the civil complaint to initiate your lawsuit.
Compensation in a Spastic Hemiplegia Malpractice Lawsuit
Over your child’s life, the costs of their care and treatment can be extremely high. The available compensation will depend on multiple factors, including the severity of your child’s condition, the nature of the doctor’s negligence, and others. Generally, however, the compensation that might be available could be significant.
Compensation in a spastic hemiplegia lawsuit is called damages. The potentially available compensatory damages include compensation for both economic and non-economic losses, including the following:
- Past, current, and future medical expenses
- Past, current, and future therapy costs
- Cost of orthotic and mobility devices
- Medication costs
- Home modification costs
- Lost wages
- Physical pain and suffering
- Reduced ability to enjoy life
- Emotional distress
Unlike some states, Pennsylvania does not cap the available compensatory damages in medical malpractice cases.
In some cases, punitive damages might be awarded. However, these types of damages are only awarded in rare cases in which a provider’s actions were particularly outrageous. If punitive damages are awarded, they are capped at no more than 200% of your compensatory damages and are paid in addition to them. Your attorney at Raynes & Lawn will carefully analyze your case and value it so that you have an idea of what it might be worth.
When to Contact a Lawyer
Pennsylvania has a statute of limitations for medical malpractice cases of no more than two years following the injury. However, the Commonwealth also has a discovery rule, which means the limitations period won’t begin to run until the date you discover your child’s condition was caused by medical malpractice or when you reasonably should have discovered it.
If you do not file a lawsuit on your child’s behalf, your child will have until they turn age 20 to file, which is two years after they turn 18. This is because the statute of limitations is tolled for minors.
Statute of limitations issues can be fairly complex. The best time to contact a lawyer at Raynes & Lawn is as soon as possible after you learn about your child’s diagnosis. If you fail to file a lawsuit on time, your claim could be dismissed by the court and prevent you from recovering compensation for the losses that your family and your child have suffered.
Consult a Birth Injury Attorney
Cerebral palsy malpractice cases are some of the most complex types of medical malpractice cases. You should consult a knowledgeable attorney who has experience handling these types of claims as soon as you learn about your child’s condition. When you get help early, your lawyer can investigate and uncover important evidence and witnesses before they might be lost. Choosing a law firm with substantial experience handling these types of malpractice cases is critical because of how aggressively insurance companies defend against them. Because of the high costs of treating cerebral palsy over a child’s life, malpractice insurers tend to be very aggressive in disputing them to avoid paying substantial compensation.
At Raynes & Lawn, our birth injury attorneys have substantial experience prosecuting cerebral palsy lawsuits against negligent medical providers. We have recovered billions of dollars on behalf of our clients over our 50 years of practice. We offer free consultations and can help you understand whether you might have a case. Call us today at 1-800-535-1797 to schedule an appointment.
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