Dyskinetic CP (also called athetoid CP) is characterized by involuntary movements and fluctuating muscle tone. Caused primarily by basal ganglia injury, it produces a distinctly different motor pattern than the stiffness of spastic CP.
Dyskinetic cerebral palsy accounts for roughly 10% to 20% of cases and is the type most closely tied to one region of the brain: around 70% of people with it have lesions visible in the basal ganglia or thalamus on MRI.
It is also the type most easily misread. The involuntary movements increase with effort and with emotion and vanish in sleep, so a child is assessed at their worst precisely when they are trying hardest, and communication difficulty here is motor rather than cognitive.
Symptoms of athetoid CP (a form of dyskinetic CP) are primarily characterized by involuntary movements and fluctuating muscle tone. Unlike spastic CP, individuals experience a mix of hypertonic (high tone) and hypotonic (low tone) episodes.
These variations make muscle control and coordination challenging. Involuntary movements (often slow and writhing) can affect any part of the body, including the face, arms, legs, and torso. The movement disorder significantly impacts motor skills, making tasks like writing, dressing, or even sitting still quite difficult.
Three patterns fall under the dyskinetic heading. Athetosis produces slow, writhing movements, most visible in the hands and face. Dystonia produces sustained muscle contractions that twist a limb into an abnormal posture. Chorea produces brief, irregular, unpredictable movements. Many children show a mixture.
Two features are characteristic. The movements increase with voluntary effort and with emotion, so they are worst exactly when a child is trying hardest. And they disappear during sleep. Dystonia is not confined to this type: roughly 70% of people with cerebral palsy have at least some dystonia.
Understanding these movements helps differentiate dyskinetic CP from other CP types and guides appropriate treatment planning.
The same fluctuating tone that affects the limbs affects the muscles controlling breath, voice and articulation, so dysarthria is common in this group. Communication difficulty here is a motor problem, and it says nothing about what the child understands, which is worth repeating because dyskinetic CP is one of the types most often underestimated on that basis.
A communication device is frequently part of the answer, and evidence indicates it does not suppress speech. See speech therapy for cerebral palsy.
These challenges can complicate communication and often benefit from speech therapy to improve articulation and clarity. Augmentative and alternative communication (AAC) technology (from picture boards to eye-gaze devices) can provide alternative means of expression. Crucially, speech difficulties don’t reflect cognitive ability; many people with dyskinetic CP have typical or above-average intelligence trapped behind a movement disorder.
Causes are varied and often involve a combination of genetic and environmental factors. The defining feature is damage to the developing brain, particularly the basal ganglia, which coordinates movement.
Advances in diagnostic techniques have improved early identification of these causes, enabling more effective intervention and treatment strategies. While genetic factors play a role, birth complications are also significant contributors.
Cerebral palsy is defined by a non-progressive brain injury, not by inheritance, and dyskinetic CP is most often linked to an identifiable perinatal event. Genetic factors are an area of active research rather than an established cause, and a genetic finding sometimes prompts a different diagnosis altogether, since several inherited movement disorders can look like dyskinetic CP early on. That distinction matters, because some of those conditions are treatable in ways cerebral palsy is not.
While not all cases are genetic, when family history points to neurological conditions, genetic counseling can be informative.
Dyskinetic cerebral palsy is more closely tied to a specific pattern of injury than the other types. Damage to the basal ganglia and thalamus, the deep structures that regulate movement, is the characteristic finding, and it is associated with acute events around birth including oxygen deprivation, premature birth and severe jaundice, where bilirubin damages those same structures.
Kernicterus, the brain injury caused by untreated severe jaundice, is a recognized and largely preventable cause. Where an acute perinatal event is involved, families sometimes ask whether it was avoidable, which our page on cerebral palsy medical malpractice addresses.
Medical advancements have improved management of high-risk pregnancies and deliveries, reducing the incidence of birth-related complications. Untreated severe jaundice is now rare in developed countries thanks to bilirubin screening, but it remains a leading preventable cause where screening is missed.
Treatment is comprehensive, aimed at managing symptoms and improving quality of life. Because dyskinetic CP involves fluctuating muscle tone rather than constant stiffness, treatment looks different than for spastic CP.
Living with dyskinetic CP can be demanding, but with the right combination of therapy, medication, and support, individuals can achieve greater independence and meaningful participation in daily life.
Strengthening is not the main lever here. The problem is control rather than power, so therapy concentrates on stabilizing posture so that purposeful movement has something to work from, on seating and positioning, and on finding the postures where a child has the most control. Physical therapy leads on posture and seating, while occupational therapy adapts the task: weighted utensils, switch access, or a stabilized surface can make an activity possible that pure practice cannot.
Because effort and emotion increase the movements, reducing the demand often improves performance more than increasing the effort does. That is counterintuitive, and it is worth raising with a therapist.
Tailored therapy plans, often developed by a multidisciplinary team, consider the unique needs of each individual, ensuring that goals are achievable and meaningful.
Because dyskinetic CP often impacts speech but not cognition, AAC matters:
Oral medications for dystonia are widely used and thinly evidenced, and physicians vary considerably in what they reach for first. Two interventions have stronger support.
Intrathecal baclofen delivers the drug directly into the fluid around the spinal cord through an implanted pump. The IDYS trial, published in Annals of Neurology in 2019, randomized 33 patients with severe cerebral palsy at GMFCS levels IV and V to three months of intrathecal baclofen or placebo, using an implanted pump in both arms so neither patient nor assessor knew which. Baclofen was superior to placebo on the primary outcome, goal attainment in daily activities, and dyskinesia impairment scores were significantly lower. Our page on medications in cerebral palsy covers the drug side more broadly.
Deep brain stimulation is the other. It significantly improves dyskinesia in reported series, but other outcomes including motor function have not consistently changed, and the evidence base is thinner than for baclofen. Both are options for severe dystonia rather than routine treatment, and both involve implanted hardware with its own complication profile. Our overview of surgery in cerebral palsy covers how they sit alongside orthopedic procedures, and support and resources covers what else families draw on.
These options require careful evaluation by specialists who weigh potential benefits against risks. A comprehensive plan that integrates medication and (when needed) surgical options can produce significant improvements in symptom management.
Diagnosis requires a thorough understanding of the condition and the use of various assessment tools. Early diagnosis is crucial for implementing effective management strategies and improving outcomes.
A comprehensive diagnosis is multidisciplinary: pediatricians, neurologists, and therapists collaborating to ensure a holistic understanding of the child’s condition. See how cerebral palsy is diagnosed for the broader workup.
MRI is the main investigation, and in dyskinetic cerebral palsy it looks at a specific region. Around 70% of people with dyskinetic CP have lesions visible in the basal ganglia or thalamus, which is a much more localized pattern than in spastic CP.
Diagnosis is still clinical rather than radiological. Imaging supports the picture built from watching how a child moves over time, which is why assessment is repeated rather than made in a single appointment.
Neuroimaging like MRI provides insights into brain structure and function. Findings in dyskinetic CP often show basal ganglia and thalamic injury, the classic pattern of severe HIE. Early and accurate diagnosis allows timely intervention.
The distinction that matters clinically is what the muscle tone does at rest. In spastic cerebral palsy tone is persistently high and the limb resists a quick stretch. In dyskinetic CP tone fluctuates, often from low at rest to high with effort or emotion, and the involuntary movements increase when the child tries to do something and disappear in sleep.
That last feature is the practical giveaway, and it is also why dyskinetic CP is so easily underestimated. Prenatal causes such as maternal infections are more often linked to the spastic types. A child whose movements worsen precisely when they are trying to perform is a child who will be assessed at their worst. See our overview of the types of cerebral palsy for how the others compare, including quadriplegic CP, which can occur alongside dyskinetic features.
Understanding the nuanced differences through clinical assessment and symptom evaluation aids accurate diagnosis. Proper identification ensures that individuals receive appropriate therapeutic interventions tailored to manage specific symptoms.
Two leading preventable causes of dyskinetic CP, severe untreated jaundice (kernicterus) and oxygen deprivation at birth (HIE), can sometimes be traced to missed screening or delayed delivery intervention. If your child’s dyskinetic CP followed either, the case may warrant a medical malpractice review. Request a free case review.
A type of cerebral palsy defined by involuntary movement rather than stiffness. It accounts for roughly 10% to 20% of cases, and around 70% of people with it have lesions in the basal ganglia or thalamus visible on MRI. Three patterns fall under it: athetosis, dystonia and chorea.
Clinically, by watching how a child moves over repeated assessments rather than in a single appointment. MRI supports the picture, and in dyskinetic CP it typically shows damage in the basal ganglia or thalamus, a more localized pattern than in spastic CP.
Damage to the basal ganglia and thalamus, the deep structures that regulate movement. It is associated with acute events around birth including oxygen deprivation and severe jaundice. Kernicterus, the brain injury from untreated severe jaundice, is a recognized and largely preventable cause.
Therapy focuses on control rather than strength: stabilizing posture, seating and positioning, and adapting the task. For severe dystonia, the IDYS trial published in Annals of Neurology in 2019 randomized 33 patients at GMFCS IV and V to intrathecal baclofen or placebo and found baclofen superior on goal attainment, with significantly lower dyskinesia scores. Deep brain stimulation improves dyskinesia but other outcomes have not consistently changed.
Dysarthria is common, because the same fluctuating tone affects the muscles controlling breath, voice and articulation. That is a motor problem and says nothing about what a child understands, which matters because dyskinetic CP is one of the types most often underestimated.
Remember that the movements increase with effort and emotion and disappear in sleep, so a child performs worst when trying hardest. Reducing the demand often improves performance more than increasing effort does, and a communication device does not suppress speech where one is needed.
Kelsey is an experienced surgical nurse who works extensively with pediatric patients and families navigating birth injuries and cerebral palsy diagnoses. She is licensed by the Missouri Board of Nursing and operates under the Nurse Licensure Compact, allowing her to practice across compact-member states. As both a mentor and patient advocate, Kelsey focuses on safety, communication, and compassionate care: helping families understand medical procedures, treatment options, and the realities of pediatric conditions.
View Kelsey Pabst, RN's full bio →
Our nurses, patient advocates and legal experts are solely focused on bringing you the latest cerebral palsy information, options for financial assistance and access to community support.
Editorial process →The information on this page is provided for general educational purposes and is not a substitute for professional medical or legal advice, diagnosis, or treatment. Always seek the guidance of a qualified physician or attorney with any questions about a medical condition or legal matter. Read our full disclaimer.
