Which cerebral palsy subtype is characterized by spastic bilateral symmetric paresis with legs greater than arms and is commonly seen with prematurity and periventricular leukomalacia?

• A. Diplegic cerebral palsy
• B. Hemiplegic cerebral palsy
• C. Quadriplegic cerebral palsy
• D. Spastic cerebral palsy

Answer: (A)

Distinguishing cerebral palsy subtypes by how the motor impairment is distributed helps identify this pattern. Spastic diplegia is defined by bilateral, symmetric weakness that affects both sides of the body but is much more pronounced in the legs than the arms. This leg‑predominant involvement is the hallmark that sets it apart from other CP forms.

Premature birth with periventricular leukomalacia fits this pattern well. PVL damages the periventricular white matter where the leg fibers of the corticospinal tracts are particularly vulnerable, leading to stronger impairment in the legs while the arms are less affected. In contrast, hemiplegia would be unilateral, quadriplegia would involve all four limbs more equally and often trunk too, and “spastic cerebral palsy” is an umbrella term for any spastic CP without specifying the distribution.