Patients with the pyramidal type of cerebral palsy and spasticity can develop a number of secondary complications including:

• Musculoskeletal (eg, contractures, scoliosis, weakness from inactivity and learned non-use)
• Nutritional problems (eg, feeding difficulties, gastroesophageal reflux) 
• Neurological problems (eg, spasticity, incontinence, seating and positioning) 
• Educational problems (eg, primary learning disorders or impaired cognition and impaired communication) 

In addition, dyskinetic patients may show an evolution of their disorder with time:

• May evolve from hypotonic to hypertonic • May maintain primitive reflexes (to their movement disorder)
• Can show progressive dystonic, athetosis and chorea 

• Go to Next section Management of spasticity in cerebral palsy Part II Passive and Active Examination