[New therapeutic methods for spasticity and dystonia in children with cerebral palsy require multidisciplinary team work. Comprehensive approach yields good results]

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.