Combined ablative neurosurgical procedures in a patient with mixed spastic and dystonic cerebral palsy.
Stereotact Funct Neurosurg
; 88(3): 187-92, 2010.
Article
in En
| MEDLINE
| ID: mdl-20431331
ABSTRACT
BACKGROUND:
Harmful generalized spasticity is an obstacle in rehabilitation and caregiving. Neurosurgical intervention is a therapeutic option for patients with severe spasticity who do not respond to nonoperative management. Currently, intrathecal baclofen therapy (ITB) is a good alternative treatment for such patients. However, the ITB device is costly and the intrathecal drug is not available in Thailand. CASE DESCRIPTION We report a combined use of ablative neurosurgical procedures in a patient with severe generalized spasticity and disabling cervical dystonia (CD). The assembled operations including selective peripheral denervation for CD, microsurgical dorsal root entry zone lesion for upper limb spasticity, and selective dorsal rhizotomy for lower limb spasticity were conducted in a single session. Furthermore, recurrent spasticity of the upper extremities was subsequently treated by selective peripheral neurotomy.RESULTS:
The spasticity and CD totally disappeared after all operations. The patient became able to sit and perform head turning. Additionally, we also found an improvement in swallowing and the voluntary movement of the lower limbs.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Torticollis
/
Brain
/
Cerebral Palsy
Limits:
Adult
/
Humans
/
Male
Language:
En
Journal:
Stereotact Funct Neurosurg
Journal subject:
NEUROCIRURGIA
Year:
2010
Type:
Article