Spasticity is a prevalent and frequently disabling motor disorder in children with cerebral palsy.¹ Cerebral palsy is the most common motor disability in childhood, leading to lifelong physical disability.^2,3

Unilateral and bilateral cerebral palsy

In monoplegia, the one limb affected is more often the lower limb.³ In hemiplegia, one side of the body is affected, and the upper limb is usually more involved than the lower limb.³ In diplegia, all limbs are affected, but the lower limbs are much more affected than the upper limbs.³ Triplegia usually has unilateral upper limb and bilateral (asymmetrical) lower limb involvement. In quadriplegia, the whole body is involved.³

More than 80% of children with cerebral palsy have upper limb involvement.⁴ Spasticity of the upper limbs affect the ability to perfom activities of daily living, such as eating, drinking, grooming and dressing.⁵

Common patterns of upper limb spasticity in children⁴

Lower limb involvement leads to a tendency for the hips to be flexed and adducted with the knees flexed and in valgus, and the ankles in equinus, resulting in toe walking.⁶

Common patterns of lower limb spasticity in children⁶

Over time, fixed contractures develop that increase disability.⁷

Children with cerebral palsy have long sarcomere lengths compared with those observed during typical child development³

Spasticity of the lower limbs results in deformity that can affect ambulation, bed positioning, sitting, chair level activities, transfers and standing up.¹¹

When used in conjunction with occupational therapy, Dysport^® can reduce muscle spasticity and optimise the effects of therapies used for enhancing motor ability and improving functional skills.^12,13

References:

1. Tilton A, et al. J Child Neurol. 2017;32(5):482–487.
2. Centre of Disease Control and Prevention. What is Cerebral Palsy? Available at: https://www.cdc.gov/ncbddd/cp/facts.html (Accessed: September 2025).
3. Graham HK, et al. Nat Rev Dis Primers. 2016;2:15082.
4. Makki D, et al. J Child Orthop. 2014;8(3):215–219.
5. Arnould C, et al. Front Neurol. 2014;4;5:48.
6. Abdel-Hamid HZ. Cerebral Palsy Clinical Presentation. Available at: https://emedicine.medscape.com/article/1179555-clinical#b3 (Accessed: September 2025).
7. Skalsky AJ and MacDonald CM. Phys Med Rehabil Clin N Am. 2012;23:675–687.
8. Pandey K. Spasticity Clinical Presentation. Available at: https://emedicine.medscape.com/article/2207448-clinical (Accessed: September 2025).
9. Hoare B, et al. BMC Neurol. 2010;10:58.
10. Lidman GRM, et al. Dev Med Child Neurol. 2020;62(2):252–258.

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