The syndrome may produce hemiplegia, paraplegia, quadriplegia, or diplegia. Affected limbs usually are underdeveloped and show increased deep tendon reflexes and muscular hypertonicity, weakness, and a tendency toward contractures. A scissors gait and toe walking are characteristic. With quadriplegia, an associated corticobulbar impairment of oral, lingual, and palatal movement, with consequent dysarthria, is common. The movements increase with emotional tension and disappear during sleep.
Dysarthria occurs and is often severe.
Weakness, incoordination, and intention tremor produce unsteadiness, a wide-based gait, and difficulty with rapid or fine movements. Strabismus and other visual defects may occur. Children with athetosis due to kernicterus commonly display nerve deafness and paralysis of upward gaze. Short attention span and hyperactivity are common. Diagnosis CP can rarely be diagnosed with certainty during early infancy, and specific syndromes often cannot be characterized until age 2 yr.