[Management of spasticity in children with cerebral palsy].
Management of spasticity is a major challenge to the rehabilitation team. The initial management has centered on the elimination of externally exacerbating causes, physical therapy, splinting and casting. Medical management has centered on anti-spasticity medication use, but more recently focal treatment methods including phenol blocks and botulinum toxin have been utilized. There has been an increased use of intrathecal baclofen in the management of refractory tone. Dorsal rhizotomy has been advocated for a selective population of children with spasticity. There is no standardized approach to spasticity management and this paper will discuss the importance of evidence-based treatment of spasticity that is adapted for the individual child.
Matthews
Dennis J
DJ
Department of Physical Therapy and Rehabilitation, Medicine Faculty of Colorado Denver University, Aurora, Colorado 80045, USA. Matthews.Dennis@tchden.org
Balaban
Birol
B
D000284:Administration, Oral; D018726:Anti-Dyskinesia Agents; D001418:Baclofen / Q000008:administration & dosage / Q000627:therapeutic use; D001569:Benzodiazepines / Q000008:administration & dosage / Q000627:therapeutic use; D001905:Botulinum Toxins; D002547:Cerebral Palsy / Q000503:physiopathology / Q000628:therapy*; D002648:Child; D003620:Dantrolene / Q000008:administration & dosage / Q000627:therapeutic use; D019317:Evidence-Based Medicine / Q000379:methods*; D018755:GABA Agonists / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D007278:Injections, Spinal; D009125:Muscle Relaxants, Central / Q000008:administration & dosage / Q000627:therapeutic use; D009128:Muscle Spasticity / Q000188:drug therapy / Q000534:rehabilitation / Q000601:surgery; D018802:Patient-Centered Care / Q000379:methods; D019800:Phenol; D019051:Rhizotomy; D013563:Sympathectomy, Chemical / Q000379:methods
D018726:Anti-Dyskinesia Agents; D018755:GABA Agonists; D009125:Muscle Relaxants, Central; D001569:Benzodiazepines; D019800:Phenol; D001905:Botulinum Toxins; D003620:Dantrolene; D001418:Baclofen