Dystonia (DYS) is defined by twisting and repetitive movements, abnormal postures due to sustained muscle contractions, and hypertonia.
These results suggest that dystonia typically has a bigger impact on functionality and a larger effect on activity, participation and quality of life than choreoathetosis.
Dystonia has a significantly higher level of severity in the distal parts of the extremities, whereas choreoathetosis is more equally distributed.
The majority of the children are born at term and experience perinatal adverse events which can be supported by neuroimaging.
Other aetiological factors are growth retardation,[11] brain maldevelopment, intracranial haemorrhage, stroke or cerebral infections.
[3] Multiple classification systems using Magnetic Resonance Imaging (MRI) have been developed, linking brain lesions to time of birth, cerebral palsy subtype and functional ability.
[12] Around 70% of patients with DCP show lesions in the cortical and deep grey matter of the brain, more specifically in the basal ganglia and thalamus.
[2] These lesions occur mostly during the peri- and postnatal period since these regions have a high vulnerability during the late third trimester of the pregnancy.
[7][19] Prevention strategies have been developed for the different risk factors of the specific cerebral palsy subtypes.
[26][27][28] Both the DIS and BFMS can be used as outcome measure in intervention studies such as deep brain stimulation (DBS)[29][30] or intrathecal baclofen.
The main goal is to improve daily activity, quality of life and autonomy of the children by creating a timed and targeted management.
Before using oral drugs, it is important to differentiate between spasticity, dystonia and choreoathetosis since each motor disorder has a specific approach.
This suggests that the discrimination of dystonia and choreoathetosis is crucial, since misinterpretations in diagnosing can contribute to the administration of inappropriate medication, causing unwanted effects.
Regarding surgical treatment in patients with DCP, deep brain stimulation (DBS) has shown to decrease dystonia.
The therapy mainly focusses on the motor problems by using principles of neuroplasticity, patterning, postural balance, muscle strengthening and stretching.
[39] The rate appeared lower in Australia, where data from states with full population-based ascertainment listed DCP as the predominant motor type in only 7% of the cases.
[40] The differences reported from various registers and countries may relate to under-identification of dyskinetic CP due to a lack of standardization in definition and classification based on predominant type.