Diplegia is a form of cerebral palsy that primarily affects muscle control and coordination in the legs. It results from brain injury or abnormal brain development. This condition is typically identified early in life and manifests as difficulties with movement and posture.
Defining Diplegia
Diplegia is a form of cerebral palsy characterized by motor impairment predominantly in the lower limbs. While the legs are more affected, the arms may still exhibit mild involvement.
The condition stems from disturbances in the developing brain. Diplegia is distinct from other forms of cerebral palsy, affecting one side (hemiplegia) or all four limbs (quadriplegia).
Causes of Diplegia
Causes of diplegia involve damage to the developing brain around birth. Prematurity, particularly with low birth weight, is a common factor. Immature brains of premature babies are more vulnerable to injury in leg movement control areas.
Lack of oxygen to the brain (hypoxia-ischemia) occurs during birth complications. Infections during pregnancy disrupt brain development. Genetic factors or brain malformations cause some cases. Despite these factors, the cause remains unknown in many cases.
Recognizing Symptoms
Parents and caregivers may notice signs of diplegia through motor development delays. Infants may struggle with milestones like crawling, sitting, or walking. Symptoms include unusual gait patterns.
A characteristic sign is a “scissoring gait,” where knees and thighs rub or cross over each other. Toe walking, or walking on the balls of their feet, is another symptom. Muscle stiffness, known as spasticity, is evident in the leg muscles, making movements rigid. Children with diplegia also experience issues with balance and coordination, affecting stability.
Diagnosis and Management
Diagnosing diplegia begins with a medical history and physical examination by a specialist. They assess developmental progress, motor skills, and reflexes. Developmental assessments help identify delays in motor milestones.
Brain imaging, like MRI, is used to identify brain damage or abnormal development. An MRI can reveal periventricular leukomalacia (PVL), a white matter injury linked to diplegia.
Management of diplegia focuses on improving mobility, function, and quality of life through a multidisciplinary approach. Physical therapy enhances muscle strength, flexibility, balance, and coordination, using exercises and stretches to reduce spasticity and improve gait. Occupational therapy helps children develop skills for daily living activities, like dressing, eating, and self-care.
Assistive devices, like walkers, crutches, or orthotics, support limb alignment and mobility. Medications (e.g., baclofen, botulinum toxin injections) reduce muscle spasticity. Sometimes, surgical interventions, like selective dorsal rhizotomy (SDR), can reduce spasticity by cutting spinal nerve fibers. Orthopedic surgeries, like tendon release, address muscle tightness and improve range of motion.
Outlook and Support
While diplegia is a lifelong condition, early intervention and consistent therapeutic management improves outcomes. Ongoing physical and occupational therapy maximizes mobility and independence throughout life. Many individuals with diplegia achieve functional independence and participate in social, educational, and recreational activities.
Outlook varies with severity and intervention effectiveness. Support from family, caregivers, and community enhances quality of life. Specialized education and adaptive technologies support participation and achievement. Ongoing medical oversight and a comprehensive care team manage evolving needs.