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Partial dorsal rhizotomy for spasticity in children with congenital brain malformations. Report of two cases
R Shane Tubbs1, Cuong J Bui, Marios Loukas
1Section of Pediatric Neurosurgery, University of Alabama at Birmingham and Children's Hospital, Birmingham, Alabama 35233, USA. rstubbs@uab.edu
Insights
Dorsal rhizotomy effectively treated spasticity in children with cerebral palsy and congenital brain malformations. These patients showed improved mobility, comparable to those without brain deformities.
Area of Science:
- Neurology
- Pediatric Neurosurgery
Background:
- Cerebral palsy (CP) is a prevalent childhood neurological disorder.
- Spasticity is a common symptom of CP, often managed with dorsal rhizotomy.
- Congenital brain malformations have historically precluded this treatment.
Observation:
- Two pediatric patients with holoprosencephaly and unilateral schizencephaly underwent dorsal rhizotomy.
- These patients had known specific congenital brain malformations.
Findings:
- Dorsal rhizotomy yielded positive outcomes in both patients.
- Long-term follow-up (mean 3.5 years) demonstrated improved ambulation, transitioning from walker to quad canes.
- Outcomes were comparable to children with spastic diplegia without brain malformations.
Implications:
- Dorsal rhizotomy may be a viable treatment for spasticity in children with congenital brain deformities.
- This expands treatment options for CP patients with complex neurological conditions.
- Further research can explore the efficacy in larger cohorts with diverse brain malformations.
Abstract:
Cerebral palsy is a common affliction in childhood. In some cases, the spasticity that often occurs can be treated with dorsal rhizotomies. Classically, these procedures have not been performed in children in whom there are known specific congenital brain malformations. The authors report on two patients with holoprosencephaly and unilateral schizencephaly who underwent dorsal rhizotomy to treat their spasticity. The results were good. The long-term benefits during a mean follow-up period of 3.5 years included the transition from using a walker to quad canes for ambulation. Additionally, the outcomes in these two children appeared comparable to those found in other children with spastic diplegia undergoing dorsal rhizotomy at the authors' institution. Dorsal rhizotomy may prove useful for treating spasticity in children with known congenital brain deformities.
