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We report two cases of spastic cerebral palsy classified as diplegia-type complicated cervical spondylotic myelopathy. Under the Gross Motor Function Classification System (GMFCS), both were classified as Level IV, defined as standing with support, but with difficultly, after the diagnosis of cervical spondylotic myelopathy. Paralysis in both the upper and lower limbs deteriorated and became a form of quadriplegia. In one case, there was no appeal from the patient even after the manifestation of symptoms；diagnosis and surgery were both time consuming, with no improvements in post-operative symptoms including urinary incontinence. In the other case, early diagnosis was possible and operation was scheduled early. The post-operative response was positive, and the patient was able to recover to pre-cervical spondylotic myelopathy conditions. Complications of cervical spondylotic myelopathy is well-known in the athetosis type；however, reports on the spastic type are limited. Here, we report complications of cervical spondylotic myelopathy in spastic cerebral palsy and show that early detection and surgery are important factors in mitigating long-term recovery.
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We report two cases of spastic cerebral palsy classified as diplegia-type complicated cervical spondylotic myelopathy. Under the Gross Motor Function Classification System (GMFCS), both were classified as Level IV, defined as standing with support, but with difficultly, after the diagnosis of cervical spondylotic myelopathy. Paralysis in both the upper and lower limbs deteriorated and became a form of quadriplegia. In one case, there was no appeal from the patient even after the manifestation of symptoms；diagnosis and surgery were both time consuming, with no improvements in post-operative symptoms including urinary incontinence. In the other case, early diagnosis was possible and operation was scheduled early. The post-operative response was positive, and the patient was able to recover to pre-cervical spondylotic myelopathy conditions. Complications of cervical spondylotic myelopathy is well-known in the athetosis type；however, reports on the spastic type are limited. Here, we report complications of cervical spondylotic myelopathy in spastic cerebral palsy and show that early detection and surgery are important factors in mitigating long-term recovery.
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<p><b>OBJECTIVE</b>To observe the effects of acupuncture at different acupoints in meridians and meridians on lower limb muscle tension in children with spastic cerebral palsy.</p><p><b>METHODS</b>Ninety children with spastic cerebral palsy aged between 2 to 6 years old were divided into a yin-meridian group, a yang-meridian group and a rehabilitation group, 30 cases in each one. The patients in the rehabilitation group were treated with routine rehabilitation treatment; the patients in the yin-meridian group were treated with routine rehabilitation treatment and acupuncture at Xuehai (SP 10), Yinlingquan (SP 9), Sanyinjiao (SP 6), Taixi (KI 3) and Taichong (LR 3) along meridians; the patients in the yang-meridian group were treated with routine rehabilitation treatment and acupuncture at Futu (ST 32), Zusanli (ST 36), Yanglingquan (GB 34), Guangming (GB 37) and Xuanzhong (GB 39) along meridians. All the three groups were treated once each other day, 10 times as one course, and totally 20-day treatment was given. Before and after treatment, modified Ashworth scale (MAS), clinical spasm index (CSI) and integrated electromyography (iEMG) of surface electromyogram of gastrocnemius muscle were evaluated.</p><p><b>RESULTS</b>Compared before treatment, the MAS and CSI in the yin-meridian group and yang-meridian group were improved after treatment (<0.05, <0.01); the differences before and after treatment in the rehabilitation group were not significant (both >0.05). After treatment, the differences between the rehabilitation group and yin-meridian group, yang-meridian group were significant (<0.05, <0.01); the differences of MAS and CSI between the yin-meridian group and yang-meridian group were not significant (both >0.05). Compared before the treatment, the right-side iEMG and left-side iEMG were reduced in the yin-meridian group and yang-meridian group (all <0.05); the right-side iEMG was increased in the rehabilitation group (<0.05). After treatment, the iEMG in the yin-meridian group and yang-meridian group were lower than that in the rehabilitation group (all <0.05); the differences of iEMG before and after treatment in the yin-meridian group and yang-meridian group were higher than that in the rehabilitation group (all <0.05); the differences of iEMG between the yin-meridian group and yang-meridian group were not significant (both >0.05).</p><p><b>CONCLUSION</b>Acupuncture at meridians and meridians could reduce muscle tension of lower limb and improve limb spasticity in children with spastic cerebral palsy, and the two acupuncture methods have similar clinical curative effect.</p>
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Objective To reveal the therapeutic efficacy of scalp acupuncture plus rehabilitation training in treating spastic cerebral palsy, by evaluating the Comprehensive Function for the Disabled Children and modified Ashworth Scale (MAS) before and after the intervention.Method Sixty patients with spastic cerebral palsy were divided into a treatment group and a control group by following a single-blind randomized design, 30 cases in each group. The treatment group was intervened by scalp acupuncture plus rehabilitation training, while the control group was by rehabilitation training alone. The improvements of comprehensive function and muscle tension, as well as the correlation between age and therapeutic efficacy were observed respectively after 2-month and 4-month treatment. Result There were significant differences in comparing the muscle tension score between the two groups respectively after2-month and 4-month treatment (P<0.01); the total effective rate was 86.7% in the treatment group versus 63.3% in the control group, and the difference was statistically significant (P<0.05); in the treatment group, there was a significant difference in comparing the therapeutic efficacy between different age groups (P<0.05).Conclusion Scalp acupuncture plus rehabilitation training can produce a better result than rehabilitation alone in treating spastic cerebral palsy; the younger the patients, the better the prognosis.
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Objective To study the risk factors related to spastic type of cerebral palsy through a screening program.Methods With a 1 ∶ 2 matched case-control study design,145 cases were selected from the Cerebral Palsy Treatment and Management Center in Heilongjiang Province from Dec.,2007 through May 2009.Another 290 cases of children as control group were chosen from the First Affiliated Hospital of Jiamusi University,in the same period.Controls were excluded the central nervous system diseases,matching with cases at the age differences no more than 3 months,with same sex and ethnicity.Questionnaire survey was used to access relevant information,while logistic regression analysis was used to screen the risk factors.Results Data from Single factor logistic regression analysis notified 39 items as statistically significant factors.Through multivariate logistic regression analysis,11 factors in all the cerebral palsy cases,and incidence of cerebral palsy risk factors related to low or high birth weight were discovered as follows:mother with college degree,newborns with high muscle tone,skin color as purple,taking antipyretic analgesics drugs during pregnancy,experience significant events during pregnancy,situation of environment pollution around the house,having intracranial hemorrhage and birth asphyxia,fetal distress during pregnancy or neonatal stage etc.Conclusion Pre/Nconatal factors were closely related to cerebral palsy,suggesting that health care knowledge be popularized and related management be strengthened,to reduce the cerebral palsy incidence in the newborns.