Cerebral Palsy & Spasticity
Cerebral palsy occurs when a child sustains a brain injury very
early on in life. Although the brain injury is static, its effects
change continuously in the growing child. The commonest cause is
premature birth. This causes damage to some of the bundles of nerve
fibres in the brain, particularly the motor nerves that control leg
movement. These nerve fibres run down from the brain to the spinal
cord and control contraction of the limb muscles. If these fibres
are damaged, the limb muscles contract too much and become stiff.
This stiffness, or spasticity, interferes with children's ability
to move and to learn to walk. Spasticity also causes pain, and,
over time, shortening of muscles and tendons, joint contractures
and severe deformities.
One of the patterns of muscle stiffness in cerebral palsy is
spastic diplegia. This predominantly involves the muscles of the
thighs, legs and feet. Nerve fibres running from the muscles back
to the spinal cord play a major role in maintaining this excessive
muscle stiffness.
There are a range of spasticity treatment options available at
Bristol Children's Hospital. The multi-disciplinary team
will assess your child and discuss the suitability of
these options with you.
These include:
- Physiotherapy and Occupational Therapy
- Orthoses
- Oral drugs
- Botulinum Toxin
- Intrathecal Baclofen
- Selective Dorsal Rhizotomy
- Orthopaedic Surgery
For more information on spasticity management for children with
Cerebral Palsy follow the link to the NICE
guidelines:
https://www.nice.org.uk/guidance/cg145
(This information can also be found within
the paediatric physiotherapy SDR
webpages.)