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Published on: August 9, 2024
[New therapeutic methods for spasticity and dystonia in children with cerebral palsy require multidisciplinary team
Lena Westbom1, Gunnar Hägglund, Annika Lundkvist
1Barnneurologiska sektionen, barn- och ungdomssjukhuset, Universitetssjukhuset i Lund. lena.westbom@skane.se
Insights
Selective Dorsal Rhizotomy (SDR) offers permanent spasticity reduction in children with cerebral palsy (CP). A multidisciplinary approach and standardized follow-up are crucial for optimal functional outcomes and preventing complications.
Area of Science:
- Neurology
- Pediatric Orthopedics
- Neurosurgery
Context:
- Cerebral palsy (CP) management involves new treatments for spasticity and dystonia.
- Selective dorsal rhizotomy (SDR), intrathecal baclofen, and botulinum toxin A are key interventions.
- A multidisciplinary approach is essential for personalized CP care.
Purpose:
- To highlight effective spasticity and dystonia reduction methods in pediatric cerebral palsy.
- To emphasize the permanent efficacy of SDR and its positive functional impact.
- To advocate for a structured, multidisciplinary follow-up program for CP management.
Summary:
- Selective dorsal rhizotomy (SDR) is the only permanent spasticity reduction method for cerebral palsy (CP).
- SDR demonstrates strong evidence for improving functional outcomes in children with CP.
- A coordinated spasticity team and standardized follow-up prevent hip dislocation and contractures.
Impact:
- SDR provides a permanent solution for spasticity in children with cerebral palsy.
- Multidisciplinary care ensures optimal treatment selection and functional improvement.
- Early intervention and standardized follow-up prevent long-term complications like hip luxation and contractures.
Abstract:
New effective methods to reduce spasticity and dystonia are now included in the treatment of children with cerebral palsy (CP): selective dorsal rhizotomy (SDR), continuous intrathecal infusion of baclofen by an implanted pump or intramuscular injections of botulinumtoxin A. SDR is the only method that can reduce the spasticity permanently. Strong evidence exists for a positive impact of SDR on the function of the children. A multidisciplinary approach is required as it is essential to choose the best treatment for each child in each developmental period. In Lund physicians and physiotherapeuts from different disciplines such as paediatric orthopaedic surgery, neurosurgery and neurology form a central spasticity team which co-operates with the local child habilitation services. We have found that a common structured and standardized follow-up programme with early intervention against muscle hypertonia and imbalance can prevent hip luxation and contractures in children with CP.
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