Publication: Ablative neurosurgery for movement disorders related to cerebral palsy
Issued Date
2015-12-01
Resource Type
ISSN
18271855
03905616
03905616
Other identifier(s)
2-s2.0-84988836285
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Mahidol University
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SCOPUS
Bibliographic Citation
Journal of Neurosurgical Sciences. Vol.59, No.4 (2015), 393-404
Suggested Citation
B. Sitthinamsuwan, S. Nunta-Aree Ablative neurosurgery for movement disorders related to cerebral palsy. Journal of Neurosurgical Sciences. Vol.59, No.4 (2015), 393-404. Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/36223
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Title
Ablative neurosurgery for movement disorders related to cerebral palsy
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Abstract
This article aims to describe the roles, operative strategies and outcomes of neuroablative procedures in treatment of movement disorders related to cerebral palsy (CP). The authors reviewed relevant medical literatures concerning ablative neurosurgical procedures for CP. Neurosurgery is an appropriate option for treatment of intractable movement disorders in CP. De-structive therapies can be selectively operated upon, on the brain, spinal cord, nerve root and peripheral nerve. Because all of them carry irreversible properties, presurgical evaluation and decision making for the surgery are critical. Selection of the procedures should be tailored for individual cases. Selective dorsal rhizotomy (SDR) is mostly suitable for CP children with spastic diplegia who are potential ambulators. Selective peripheral neurotomy (SPN) aims to diminish localized hypertonia. Intractable painful spasticity in an entire useless limb can be effectively treated by dorsal root entry zone lesion (DREZotomy). Stereotactic coagulation of specific targets in the brain is appropriate for more diffuse movement disorders or hyperkinesias confined to one side of the body. Combined surgery should be employed in management of more complicated abnormalities or coexisting neurologic and orthopedic disorders. Neuroablation remains an alternative to neuromodulation therapy, especially in circumstances when the latter is unavailable.