These include spastic paralysis of a single limb or a spastic diplegia as illustrated when both legs are involved and the patient walks with a 'scissor gait'. In severe cerebral palsy all 4 limbs can be involved with associated severe mental impairment. In cerebral palsy the muscles are spastic, and are of normal bulk unlike the severe wasting of a flaccid paralysis. The reflexes are increased. The flexion contractures of joints can often be straightened.
Sensation is usually unaffected or only partially diminished.
Other causes of spasticity of the limbs in both childhood and adults include head injuries, and any cerebral vascular haemorrage, thrombosis or embolus. They also include cerebral tumours as illustrated, as well as infections such as meningitis. Syringomyelia is a congenital condition which usually involves the central canal of the cervical spinal cord, and initally leads to dissociated sensory loss in the upper limb before leading to more generalised paralysis. This classically causes a Charcot degeneration of the shoulders with considerable destruction of the shoulder joint. Despite this, the shoulders are not only often more mobile than normal, but also virtually painless.