Nervenheilkunde 2007; 26(05): 396-404
DOI: 10.1055/s-0038-1626876
Original Article
Schattauer GmbH

Zerebralparese – Übersicht und interdisziplinäre Therapie

Cerebral palsy – overview and interdisciplinary therapy
U. M. Fietzek
1   Neurologisches Krankenhaus München
,
B. Wiedenhöfer
2   Stiftung Orthopädie, Universität Heidelberg
,
L. Döderlein
2   Stiftung Orthopädie, Universität Heidelberg
,
S. Berweck
3   Dr. von Hauner’sches Kinderspital, Abt. für Pädiatrische Neurologie und Entwicklungsneurologie, Ludwig-Maximilians-Universität München
› Author Affiliations
Further Information

Publication History

Eingegangen am: 31 January 2007

angenommen am: 09 February 2007

Publication Date:
20 January 2018 (online)

Zusammenfassung

Zerebralparesen sind die häufigste Ursache einer spastischen Bewegungsstörung im Kindesalter. Der Artikel stellt aktuelle pathophysiologische Konzepte zur Zerebralparese dar und gibt einen Überblick über die interdisziplinären Behandlungsmöglichkeiten der motorischen Störung. Insbesondere wird auf funktionelle Therapien, auf die Behandlung mit Botulinumtoxin, sowie auf orthopädische Verfahren eingegangen.

Summary

Cerebral palsy is the most common disease that leads to a spastic movement disorder in childhood. The paper reviews the actual pathophysiological concepts and summarises the interdisciplinary therapy approach of the motor disorder. It focuses on functional therapy, the treatment with Botulinum Toxin and orthopaedic interventions.

 
  • Literatur

  • 1 Little WJ. On the influence of abnormal parturition, difficult labours, premature birth, and asphyxia neonatorum, on the mental and physical condition of the child, especially in relation to deformities. (originally published 1862). Cerebral Palsy Bulletin 1958; 01: 5-36.
  • 2 Surveillance of cerebral palsy in Europe: a collaboration of cerebral palsy surveys and registers. Surveillance of Cerebral Palsy in Europe (SCPE). Dev Med Child Neurol 2000; 42 (12) 816-824.
  • 3 Ashwal S, Russman BS, Blasco PA, Miller G, Sandler A, Shevell M. et al. Practice parameter: diagnostic assessment of the child with cerebral palsy: report of the Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society. Neurology 2004; 62 (06) 851-863.
  • 4 Palisano R, Rosenbaum PL, Walter S, Russell D, Wood E. Development and reliability of a system to classify gross motor function in children with cerebral palsy. Dev Med Child Neurol 1997; 39 (04) 214-223.
  • 5 Rosenbaum PL, Walter SD, Hanna SE, Palisano RJ, Russell DJ, Raina P. et al. Prognosis for gross motor function in cerebral palsy: creation of motor development curves. Jama 2002; 288 (11) 1357-1363.
  • 6 Petruch U, Weber PM, Krageloh-Mann I. SCPE obot. The reference and training manual of the SCPE (Surveillance of Cerebral Palsy in Europe). Neuropediatrics 2004; 35: 63.
  • 7 Eyre JA, Miller S, Ramesh V. Constancy of central conduction delays during development in man: investigation of motor and somatosensory pathways. J Physiol 1991; 434: 441-452.
  • 8 Stanley FJ. Survival and cerebral palsy in low birthweight infants: implications for perinatal care. Paediatr Perinat Epidemiol 1992; 06 (02) 298-310.
  • 9 Paneth N. The causes of cerebral palsy. Recent evidence. Clin Invest Med 1993; 16 (02) 95-102.
  • 10 Zupan V, Gonzalez P, Lacaze-Masmonteil T, Boithias C, d’Allest AM, Dehan M. et al. Periventricular leukomalacia: risk factors revisited. Dev Med Child Neurol 1996; 38 (12) 1061-1067.
  • 11 Jarvis S, Glinianaia SV, Torrioli MG, Platt MJ, Miceli M, Jouk PS. et al. Cerebral palsy and intrauterine growth in single births: European collaborative study. Lancet 2003; 362 (9390): 1106-1111.
  • 12 Damiano DL. Activity, activity, activity: rethinking our physical therapy approach to cerebral palsy. Phys Ther 2006; 86 (11) 1534-1540.
  • 13 Andersson C, Grooten W, Hellsten M, Kaping K, Mattsson E. Adults with cerebral palsy: walking ability after progressive strength training. Dev Med Child Neurol 2003; 45 (04) 220-228.
  • 14 Taylor NF, Dodd KJ, Damiano DL. Progressive resistance exercise in physical therapy:a summary of systematic reviews. Phys Ther 2005; 85 (11) 1208-1223.
  • 15 Blundell SW, Shepherd RB, Dean CM, Adams RD, Cahill BM. Functional strength training in cerebral palsy: a pilot study of a group circuit training class for children aged 4–8 years. Clin Rehabil 2003; 17 (01) 48-57.
  • 16 Dodd KJ, Foley S. Partial body-weight-supported treadmill training can improve walking in children with cerebral palsy: a clinical controlled trial. Dev Med Child Neurol 2007; 49 (02) 101-105.
  • 17 Dodd KJ, Taylor NF, Graham HK. A randomized clinical trial of strength training in young people with cerebral palsy. Dev Med Child Neurol 2003; 45 (10) 652-657.
  • 18 Bodkin AW, Baxter RS, Heriza CB. Treadmill training for an infant born preterm with a grade III intraventricular hemorrhage. Phys Ther 2003; 83 (12) 1107-1118.
  • 19 Schindl MR, Forstner C, Kern H, Hesse S. Treadmill training with partial body weight support in nonambulatory patients with cerebral palsy. Arch Phys Med Rehabil 2000; 81 (03) 301-306.
  • 20 McNevin NH, Coraci L, Schafer J. Gait in adolescent cerebral palsy: the effect of partial unweighting. Arch Phys Med Rehabil 2000; 81 (04) 525-528.
  • 21 Elbert T, Rockstroh B, Bulach D, Meinzer M, Taub E. [New developments in stroke rehabilitation based on behavioral and neuroscientific principles: constraint-induced therapy]. Nervenarzt 2003; 74 (04) 334-342.
  • 22 Taub E, Ramey SL, DeLuca S, Echols K. Efficacy of constraint-induced movement therapy for children with cerebral palsy with asymmetric motor impairment. Pediatrics 2004; 113 (02) 305-312.
  • 23 Eliasson AC, Krumlinde-sundholm L, Shaw K, Wang C. Effects of constraint-induced movement therapy in young children with hemiplegic cerebral palsy: an adapted model. Dev Med Child Neurol 2005; 47 (04) 266-275.
  • 24 de Paiva A, Meunier FA, Molgo J, Aoki KR, Dolly JO. Functional repair of motor endplates after botulinum neurotoxin type A poisoning: biphasic switch of synaptic activity between nerve sprouts and their parent terminals. Proc Natl Acad Sci U S A 1999; 96 (06) 3200-3205.
  • 25 Mahrhold S, Rummel A, Bigalke H, Davletov B, Binz T. The synaptic vesicle protein 2C mediates the uptake of botulinum neurotoxin A into phrenic nerves. FEBS Lett 2006; 580 (08) 2011-2014.
  • 26 Rosales RL, Bigalke H, Dressler D. Pharmacology of botulinum toxin: differences between type A preparations. Eur J Neurol 2006; 13 Suppl 1: 2-10.
  • 27 Berweck S, Feldkamp A, Francke A, Nehles J, Schwerin A, Heinen F. Sonography-guided injection of botulinum toxin A in children with cerebral palsy. Neuropediatrics 2002; 33 (04) 221-223.
  • 28 Berweck S, Schroeder AS, Fietzek UM, Heinen F. Sonography-guided injection of botulinum toxin in children with cerebral palsy. Lancet 2004; 363 (9404): 249-250.
  • 29 Mall V, Heinen F, Siebel A, Bertram C, Hafkemeyer U, Wissel J. et al. Treatment of adductor spasticity with BTX-A in children with CP: a randomized, double-blind, placebo-controlled study. Dev Med Child Neurol 2006; 48 (01) 10-13.
  • 30 Ackman JD, Russman BS, Thomas SS, Buckon CE, Sussman MD, Masso P. et al. Comparing botulinum toxin A with casting for treatment of dynamic equinus in children with cerebral palsy. Dev Med Child Neurol 2005; 47 (09) 620-627.
  • 31 Reddihough DS, King JA, Coleman GJ, Fosang A, McCoy AT, Thomason P. et al. Functional outcome of botulinum toxin A injections to the lower limbs in cerebral palsy. Dev.Med.Child Neurol 2002; 44 (12) 820-827.
  • 32 Baker R, Jasinski M, Maciag-Tymecka I, Michalowska-Mrozek J, Bonikowski M, Carr L. et al. Botulinum toxin treatment of spasticity in diplegic cerebral palsy: a randomized, double-blind, placebo-controlled, dose-ranging study. Dev Med Child Neurol 2002; 44 (10) 666-675.
  • 33 Polak F, Morton R, Ward C, Wallace WA, Doderlein L, Siebel A. Double-blind comparison study of two doses of botulinum toxin A injected into calf muscles in children with hemiplegic cerebral palsy. Dev Med Child Neurol 2002; 44 (08) 551-555.
  • 34 Ubhi T, Bhakta BB, Ives HL, Allgar V, Roussounis SH. Randomised double blind placebo controlled trial of the effect of botulinum toxin on walking in cerebral palsy. Arch Dis Child 2000; 83 (06) 481-487.
  • 35 Barwood S, Baillieu C, Boyd R, Brereton K, Low J, Nattrass G. et al. Analgesic effects of botulinum toxin A: a randomized, placebo-controlled clinical trial. Dev Med Child Neurol 2000; 42 (02) 116-121.
  • 36 Koman LA, Mooney JF, Smith BP, Walker F, Leon JM. Botulinum toxin type A neuromuscular blockade in the treatment of lower extremity spasticity in cerebral palsy: a randomized, double-blind, placebo-controlled trial. BOTOX Study Group. J Pediatr Orthop 2000; 20 (01) 108-115.
  • 37 Sutherland DH, Kaufman KR, Wyatt MP, Chambers HG, Mubarak SJ. Double-blind study of botulinum A toxin injections into the gastrocnemius muscle in patients with cerebral palsy. Gait Posture 1999; 10 (01) 1-9.
  • 38 Flett PJ, Stern LM, Waddy H, Connell TM, Seeger JD, Gibson SK. Botulinum toxin A versus fixed cast stretching for dynamic calf tightness in cerebral palsy. J Paediatr Child Health 1999; 35 (01) 71-77.
  • 39 Corry IS, Cosgrove AP, Duffy CM, McNeill S, Taylor TC, Graham HK. Botulinum toxin A compared with stretching casts in the treatment of spastic equinus: a randomised prospective trial. J Pediatr Orthop 1998; 18 (03) 304-311.
  • 40 Lowe K, Novak I, Cusick A. Low-dose/high-concentration localized botulinum toxin A improves upper limb movement and function in children with hemiplegic cerebral palsy. Dev Med Child Neurol 2006; 48 (03) 170-175.
  • 41 Speth LA, Leffers P, Janssen-Potten YJ, Vles JS. Botulinum toxin A and upper limb functional skills in hemiparetic cerebral palsy: a randomized trial in children receiving intensive therapy. Dev Med Child Neurol 2005; 47 (07) 468-473.
  • 42 Fehlings D, Rang M, Glazier J, Steele C. An evaluation of botulinum-A toxin injections to improve upper extremity function in children with hemiplegic cerebral palsy. J Pediatr 2000; 137 (03) 331-337.
  • 43 Corry IS, Cosgrove AP, Walsh EG, McClean D, Graham HK. Botulinum toxin A in the hemiplegic upper limb: a double-blind trial. Dev Med Child Neurol 1997; 39 (03) 185-193.
  • 44 Jongerius PH, Rotteveel JJ, van Limbeek J, Gabreels FJ, van Hulst K, van den Hoogen FJ. Botulinum toxin effect on salivary flow rate in children with cerebral palsy. Neurology 2004; 63 (08) 1371-1375.
  • 45 Heinen F, Molenaers G, Fairhurst C, Carr LJ, Desloovere K, Chaleat EValayer. et al. European consensus table 2006 on botulinum toxin for children with cerebral palsy. Eur J Paediatr Neurol 2006; 10 5–6 215-225.
  • 46 Penn RD, Kroin JS. Continuous intrathecal baclofen for severe spasticity. Lancet 1985; 02 (8447): 125-127.
  • 47 Campbell WM, Ferrel A, McLaughlin JF, Grant GA, Loeser JD, Graubert C. et al. Long-term safety and efficacy of continuous intrathecal baclofen. Dev Med Child Neurol 2002; 44 (10) 660-665.
  • 48 Albright AL. Intrathecal baclofen in cerebral palsy movement disorders. J Child Neurol 1996; 11 Suppl 1: S29-35.
  • 49 Zuniga RE, Schlicht CR, Abram SE. Intrathecal baclofen is analgesic in patients with chronic pain. Anesthesiology 2000; 92 (03) 876-880.
  • 50 Rang M, Silver R, De la Garca J. Cerebral Palsy. In: Lovell WW, Winter RB. editors. Pediatric Orthopedics. 2nd ed. Philadelphia: Lippincott; 1986
  • 51 Graham HK. Painful hip dislocation in cerebral palsy. Lancet 2002; 359 (9310): 907-908.
  • 52 Ziv I, Blackburn N, Rang M, Koreska J. Muscle growth in normal and spastic mice. Dev Med Child Neurol 1984; 26 (01) 94-99.
  • 53 Cosgrove A, Graham H. Botulinum toxin A prevents the development of contractures in the hereditary spastic mouse. Dev Med Child Neurol 1994; 36: 379-385.
  • 54 Crothers B, Paine RS. Natural History of Cerebral Palsy. Cambridge: Harvard University Press; 1959
  • 55 Morris C. A review of the efficacy of lower-limb orthoses used for cerebral palsy. Dev Med Child Neurol 2002; 44 (03) 205-211.
  • 56 Reime U, Riedel M. Wirksamkeit dynamischer Sprunggelenk (DAFO) und Fussorthesen (DFO) nach Hylton auf die grobmotorische Funktion zerebral bewegungsgestörter Kinder. Orthopädische Praxis 2000; 36: 622-628.
  • 57 Fuchs A, Döderlein L. Orthotics and cerebral palsy. Established treatments and trends in orthopaedic devices for patients with cerebral palsy. Orthopäde 2004; 33: 1173-1182.
  • 58 Gage JR. Gait analysis in cerebral palsy. London: MacKeith Press; 1991
  • 59 Döderlein L, Metaxiotis D. Knee-bending and-stretching-spastic ininfant cerebral palsy. Surgery aimed at functional improvement and its results. Orthopäde 2004; 33: 1138-1151.
  • 60 Rodda J, Graham HK. Classification of gait patterns in spastic hemiplegia and spastic diplegia: a basis for a management algorithm. Eur J Neurol 2001; 8 Suppl 5: 98-108.
  • 61 Abel MF, Damiano DL, Pannunzio M, Bush J. Muscle-tendon surgery in diplegic cerebral palsy: functional and mechanical changes. J Pediatr Orthop 1999; 19 (03) 366-375.