Which motor pattern is characteristic of spastic cerebral palsy?

• A. Hypertonia with brisk reflexes
• B. Hypotonia with reduced reflexes
• C. Involuntary choreiform movements with fluctuating tone
• D. Normal tone with no motor abnormalities

Answer: (D)

Spastic cerebral palsy is driven by upper motor neuron injury that raises muscle tone and reflex responsiveness. The muscles become unusually stiff, and deep tendon reflexes are brisk, often with an extensor plantar response and patterned stiff or scissoring movements in the legs. This hypertonic state with heightened reflexes is the hallmark of the spastic form. Hypotonia with reduced reflexes describes non-spastic or different CP types, not spastic. Involuntary choreiform movements with fluctuating tone point to a dyskinetic CP type, where tone can swing and movement is dominated by involuntary motions rather than persistent stiffness. Normal tone with no motor abnormalities would not fit CP. So the pattern most characteristic of spastic CP is hypertonia with brisk reflexes.