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  • Print publication year: 2006
  • Online publication date: August 2010

39 - Cerebral palsy and paediatric neurorehabilitation

from Section C - Disease-specific neurorehabilitation systems

Summary

Cerebral palsy (CP) is the common diagnostic cause of the upper motor neurone (UMN) syndrome in childhood, a syndrome characterised by positive features and negative features. In CP, spasticity has both neurophysiological and musculoskeletal components. While traditional clinical evaluation of spasticity include symptoms and signs together with examination of muscle tone, range of movement (ROM), and functional impact, assessment also include validated quantitative and qualitative instruments. Oral medications affect muscles involved to varying degrees of spasticity, including both the target muscles and those for which loss of tone and/or function is undesirable. Combination treatment, such as botulinum toxin A (BoNT-A) or orthopaedic surgery, physical therapy and oral baclofen are used in clinical practice with anecdotal benefit, but the results of further scientific studies to prove the extra benefit are awaited. While selective dorsal rhizotomy (SDR) reduces spasticity, it has no effect on selective motor control (SMC), balance or fixed deformities.

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