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Seminars in Neurosurgery 2002; 13(1): 047-060
DOI: 10.1055/s-2002-35247
Copyright © 2002 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Neurosurgical Management of Hypertonia in Children

Paul Steinbok
  • Division of Pediatric Neurosurgery, Department of Surgery, University of British Columbia, Canada; and Division of Pediatric Neurosurgery, Section of Surgery, British Columbia's Children's Hospital, Vancouver, British Columbia, Canada
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Publication History

Publication Date:
04 November 2002 (online)

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ABSTRACT

Hypertonia, whether it is spasticity, dystonia or a combination, is an important clinical problem in children and is most commonly associated with cerebral palsy. In this review of the management of hypertonia in children with cerebral palsy, the multidisciplinary nature of the management is stressed. The various modalities of treatment are discussed, with the emphasis on the neurosurgical aspects of management. The two major neurosurgical treatments, namely selective dorsal rhizotomy and intrathecal baclofen, are reviewed in detail. Current knowledge about outcomes with these treatments is presented according to a paradigm developed by the National Center for Medical Rehabilitation Research. Guidelines are provided for the selection of the different treatment modalities.

KEYWORDS

Spasticity - dystonia - hypertonia - dorsal rhizotomy - intrathecal baclofen - cerebral palsy

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