The four types of cerebral palsy are spastic, dyskinetic, ataxic, and mixed. Each type is defined by the kind of movement problem it causes, which depends on where in the brain the damage occurred. Spastic cerebral palsy is by far the most common, accounting for roughly 77% of all cases.
Spastic Cerebral Palsy
Spastic cerebral palsy affects about 80% of people with CP, according to the CDC. The defining feature is increased muscle tone, meaning the muscles are abnormally stiff. This stiffness makes movements look awkward, jerky, or repetitive. In infants, exaggerated reflexes and rigid limbs are often the earliest signs.
Spastic CP is further broken down by which parts of the body are involved. Spastic diplegia primarily affects the legs, so a child may walk with a scissored gait where the knees cross or press together. Spastic hemiplegia affects one side of the body, often with the arm more involved than the leg. Spastic quadriplegia is the most severe form, affecting all four limbs, the trunk, and often the muscles of the face and mouth. Children with quadriplegia frequently have difficulty swallowing, speaking, and sitting without support.
Dyskinetic Cerebral Palsy
Dyskinetic CP (sometimes called athetoid CP) involves uncontrollable movements of the hands, feet, arms, or legs. Unlike the constant stiffness of spastic CP, muscle tone in dyskinetic CP can swing between too tight and too loose, sometimes even within the same day. That fluctuation is what makes voluntary movement so difficult.
The involuntary movements fall into three patterns. Dystonia produces twisting, repetitive postures. Chorea looks like quick, dance-like, jerky motions. Athetosis involves slow, writhing movements, particularly in the fingers, hands, and feet. Many children show a combination of these patterns rather than just one.
The face and tongue are frequently affected. This can cause drooling, grimacing, and significant trouble with sucking, swallowing, and speaking. Sitting upright and walking are also challenging because the trunk muscles are difficult to control. Dyskinetic CP accounts for only about 2.6% of all cerebral palsy cases, making it far less common than the spastic type.
Ataxic Cerebral Palsy
Ataxic CP disrupts balance, coordination, and depth perception. It accounts for roughly 2.4% of cases. Children with this type walk with an unsteady, wide-based gait, placing their feet farther apart than hip width to compensate for poor balance. Their movements can look clumsy or uncoordinated in a way that is sometimes mistaken for being “under the influence,” as the Cleveland Clinic notes.
Precise, controlled movements are especially hard. A child reaching for a cup might overshoot it, then overcorrect, then overshoot again. Fine motor tasks like writing, buttoning a shirt, or tying shoes require a level of coordination that ataxic CP directly impairs. Tremors or shaking during purposeful movement are common.
Speech can also be affected. Some children develop what’s called scanning speech, where there are noticeable pauses between words and syllables. Their voice may sound monotone, without the natural rise and fall of pitch. Swallowing difficulties and loud breathing patterns can accompany these speech changes.
Mixed Cerebral Palsy
Mixed CP means a person shows symptoms of more than one type. The most common combination is spastic-dyskinetic, where a child has both the muscle stiffness of spastic CP and the involuntary movements of dyskinetic CP. Surveillance data suggests that mixed and other classifications account for about 15% of all cerebral palsy cases, making this a sizable group.
Because mixed CP involves overlapping movement problems, it can be harder to classify and often requires more individualized treatment planning. A child might have stiff legs typical of spastic diplegia along with the writhing hand movements seen in dyskinetic CP. The severity and combination vary widely from person to person.
What Determines the Type
The type of cerebral palsy a child develops depends on which area of the brain was damaged and when the damage occurred. Spastic CP results from injury to the parts of the brain that control voluntary movement and muscle tone. Dyskinetic CP is linked to damage in deeper brain structures that help regulate smooth, coordinated motion. Ataxic CP stems from problems in the area of the brain responsible for balance and fine motor coordination.
The damage itself can happen before, during, or shortly after birth. Regardless of timing, cerebral palsy is non-progressive, meaning the brain injury doesn’t get worse over time, though the way symptoms show up in the body can change as a child grows.
How Severity Is Measured
Knowing the type of CP only tells part of the story. Doctors also assess how much the condition affects daily movement using the Gross Motor Function Classification System, a five-level scale. At Level I, a child can walk without restrictions but may struggle with advanced motor skills like running or jumping. At Level V, a child has very limited ability to move independently, even with assistive devices like wheelchairs or walkers.
Two children with the same type of cerebral palsy can function very differently depending on where they fall on this scale. A child with spastic hemiplegia at Level I might walk independently and participate in most activities, while another child with spastic quadriplegia at Level V may need full-time physical support. The classification system helps families and therapists set realistic goals and choose the right combination of physical therapy, mobility aids, and other supports.