Mixed cerebral palsy

Mixed cerebral palsy causes a blend of symptoms like stiffness, floppy limbs, or trouble with balance. It can be hard to spot early and even harder to understand why it happened. Some cases trace back to complications during birth. Learn what mixed CP means, what to watch for, and how to get help.

What is mixed cerebral palsy?

Mixed cerebral palsy happens when a child shows signs of more than one type of CP. It often develops due to damage in multiple areas of the brain that control movement and coordination.

Some parents notice early signs like stiffness, low muscle tone, or delays in rolling or sitting. Others receive a diagnosis after their child misses key developmental milestones. In many cases, families are left without clear answers about what caused the condition.

Cerebral Palsy Guide is committed to helping families affected by all types of cerebral palsy. Our team includes labor and delivery nurses with decades of combined experience supporting parents through complex birth injuries.

If your child was diagnosed with mixed cerebral palsy or is showing signs, our nurses are here to help you understand what happened and what steps to take next.

Mixed cerebral palsy symptoms

Because every child with cerebral palsy is different, the symptoms of mixed cerebral palsy can vary widely. Most children show a combination of movement challenges from more than one CP type, and the severity often depends on how much of the brain was affected.

The most common signs of mixed-type cerebral palsy involve problems with movement, balance, and muscle control.

Other symptoms of mixed cerebral palsy may include:

• Abnormal reflexes

• Exaggerated or jerky movements

• Poor posture

• Tremors or shakiness

• Trouble with coordination and motor planning

Although mixed cerebral palsy can involve features from any combination of CP types, the most common patterns are spastic/athetoid and spastic/ataxic.

Here are 5 early red flags to watch for:

1. NICU stay after birth
   Babies with oxygen loss, low Apgar scores, or other complications may need care in the neonatal intensive care unit (NICU). This is sometimes the first sign of a serious birth-related injury.

2. Cooling treatment
   If your baby was placed on a cooling blanket or received therapeutic hypothermia, this often means doctors were trying to limit brain damage after a traumatic delivery.

3. Unusual muscle tone
   Babies with mixed tone cerebral palsy may feel either too stiff or too floppy. They may have difficulty holding their head up or supporting their limbs.

4. Missing early milestones
   Delays in rolling over, sitting up, crawling, or babbling are early developmental delays that may point to cerebral palsy.

5. Trouble moving both sides of the body
   Your baby may appear weaker on one side, have trouble reaching, or seem to favor one hand or leg very early on.

These signs are sometimes dismissed or explained away. If you’re unsure what’s causing your child’s symptoms, our team can help you find answers.

Causes of mixed cerebral palsy

Mixed cerebral palsy is caused by brain damage to more than one area of the brain. This often happens during pregnancy, labor, or shortly after birth. When multiple motor control centers are affected, it can lead to overlapping symptoms from different types of CP.

Some known causes of brain damage linked with CP include:

• Brain bleeds before or during delivery (intraventricular hemorrhage)

• Infections during pregnancy or in the newborn period

• Lack of oxygen at birth (birth asphyxia or hypoxia)

• Meningitis in the first weeks of life

• Severe, untreated jaundice after birth (kernicterus)

• Stroke or blocked blood flow in the brain

Other types of cerebral palsy

Other types of cerebral palsy

Children with mixed cerebral palsy often show symptoms from more than one type of CP. Understanding the main cerebral palsy types can help parents recognize how different movement issues may appear in a mixed diagnosis.

The four main types of cerebral palsy are:

1. Spastic cerebral palsy: Most common type, high muscle tone causes stiffness, tightness, and jerky or awkward movements

2. Athetoid or dyskinetic cerebral palsy: Muscle tone fluctuates between stiff and loose, leading to writhing or uncontrolled movements

3. Ataxic cerebral palsy: Poor balance and coordination affect walking, posture, fine motor skills, and precise movements

4. Hypotonic cerebral palsy: Low muscle tone results in floppy muscles and trouble with head control, sitting, or other voluntary movements