Diplegia: Description, Causes and Risk Factors:Paralysis of corresponding parts on both sides of the bodyTerminology related with diplegia include congenital facial diplegia, infantile diplegia, masticatory diplegia, and spastic diplegia.ICD-9-CM: 344.2.DiplegiaTypes of diplegia: Congenital facial, facial, infantile, masticatory, and spastic.Diplegia is a form of CP (cerebral palsy) primarily affecting the legs. Most children with CP will also have some problem with their arms but with diplegia they are less involved and less severe. Most children with diplegia have spasticity, and have difficulty with balance and coordination. Delayed muscle growth and spasticity cause their leg muscles to be short, and as a result the range of motion can decrease as a child grows and the joints become stiff. The feet and ankles present more problems than the knees due to a short tight Achilles tendon, which can lead to toe walking. There is risk that the hips may become dislocated and for this reason, the child's hips must be closely monitored.There are different classifications for the degree of severity of disability for children with a diplegic form of CP: mild, moderate and severe. A child with mild diplegia can walk without the use of aids, has a normal tolerance for walking and can keep up with non-disabled children of a similar age in activities where walking is involved. A child with moderate diplegia is able to walk for most daily activities although he or she may choose to use an aid at times such as crutches or a walker. Where lengthy walking is involved such as a trip to a zoo, amusement park or shopping mall, the child with moderate involvement would need the use of a wheelchair. A child with severe involvement would require an aid for even walking small distances and will only walk on level ground in uncrowded areas. A wheelchair is used when getting around in public.Many  children with the disease were born prematurely and have had respiratory problems. Most have normal or near-normal learning abilities. Most  children are eventually able to walk, though many begin walking late.Diagnosis:Diplegia, like other forms of CP, is hard to detect early on. Warning sings may include stiff lower extremities or floppiness of the limbs that turn stiff later. There are no tests or scans that can detect CP, and it has to be diagnosed based on motor movement.Most cases of spastic diplegia are diagnosed before the child is three. Developmental delay can be an early sign of CP in infants and it is the sign parents most often notice and bring to the attention of their pediatrician. Babies with CP may have unusual muscle tone. They may be rigid or stiff or they may seem floppy and unable to hold their head at a normal angle. The stiffness is caused by increased muscle tone (hypertonia), while floppiness is caused by decreased muscle tone (hyptonia). Sometimes a baby may begin appearing overly relaxed and then become increasingly stiff; this generally occurs at age two to three months.Treatment Options:For the child with mild diplegia, replacing therapy with other physical activities, such as swimming, dance class, karate, or horseback riding, is a good idea because the child's interest will keep her active in developing her motor skills.Physical therapy is the standard treatment is used for all CP patients. Physical therapy prevents spastic muscles from becoming contracted (unable to move) and it strengthens muscles which would otherwise become weak from disuse. There are several different methods of physical therapy used for spastic diplegia.Other treatments for spastic D and other forms of CP range from medicines to reduce muscle tension to orthopedic surgery to correct CP induced deformities. Braces and other orthopedic supports are helpful for some patients.Today, some spastic diplegia patients are finding relief from alternative therapies such as massage, yoga and chiropractic adjustments. Massage therapists believe that gentle massage helps  patients relax and sleep better.DISCLAIMER: This information should not substitute for seeking responsible, professional medical care. 


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