Cerebral Palsy Muscular Contractures and Spasticity
About half of all children with cerebral palsy develop spasticity, in which their muscles tighten involuntarily.
There are three main forms of spasticity:
- Spastic hemiplegia (only one side of the body is involved)
- Spastic diplegia (lower extremities are more involved than the upper)
- Spastic quadriplegia (all four extremities are involved)
Spastic muscles do not grow normally, and over time, permanent muscle contracture (tightening) and deformity can develop. In children with diplegic cerebral palsy, contractures worsen around the ages of four to five, and the child's ability to walk either does not improve or deteriorates.
How we can help — treatment options
BOTOX is a drug developed from the botulinus toxin that works as a neuromuscular blocking agent. BOTOX can be injected into the spastic muscle, weakening the muscle for four to six months. Used in minute amounts, it safely relaxes muscles and delays the need for surgery.
Muscle lengthening procedures may be performed surgically to improve joint motion and gait (walking), and to prevent deformities. We design surgeries to correct as many contractures as possible during a single trip to the operating room. Download an information sheet (PDF) on muscle lengthing procedures.
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Physical therapy is beneficial at an early age when children have cerebral palsy. It is also key after surgical procedures. Our expert rehabilitation staff will work with your child to design therapy for his or her individual needs. After surgery on most walking children, only below-knee casts are used. Therapy to promote maximum joint motion, muscle strengthening and a return to walking can begin in the days immediately after the procedure.
Selective dorsal rhizotomy is a surgical procedure used to treat spasticity, particularly spasticity as seen in young children with cerebral palsy.
The Baclofen pump helps deliver medications directly to the spinal area.