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  • Print publication year: 2008
  • Online publication date: August 2009

12 - Management of spasticity in children

Summary

Spasticity in children continues to be a common and challenging problem for the foreseeable future. While reduction in the incidence of cerebral palsy would have the most impact in reducing the overall incidence of spasticity in children, prevention of traumatic brain injury and spinal cord injury is probably more realistic. Fixed musculoskeletal pathology in cerebral palsy is acquired during childhood. Children with cerebral palsy do not have contractures, dislocated hips or scoliosis at birth. These common deformities are acquired during childhood. There are few useful clinical measures of spasticity and none validated for use in children. The Ashworth and modified Ashworth scales are blunt and unresponsive tools in the assessment of the child with cerebral palsy. Botulinum toxin A (BoNT-A) is a reversible, focal agent which has been under evaluation since the early 1990s in the management of spasticity in children.

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RECOMMENDED READING
Dormans, J. P. & Pellegrino, L. (eds.). (1998). Caring for Children with Cerebral Palsy: A Team Approach. Baltimore: Paul H. Brookes.
Miller, G. & Clark, G. D. (eds.). (1988). The Cerebral Palsies: Causes, Consequences and Management. Boston: Butterworth-Heinemann.
Sussman, M. D. (ed.). (1992). The Diplegic Child. Rosemont, IL: American Academy of Orthopaedic Surgeons.