Neurosurgical intervention during resistant phase of motor development of cerebral palsied.

ABSTRACT

Positive neurological phenomena of cerebral palsied, especially spasticity are best relieved by neurosurgical procedures. But the procedures are indicated only in those cases who have developed resistance to nonsurgical therapies, especially rehabilitative therapy. However, surgical procedure cannot teach a child how to perform motor functions. Therefore, rehabilitative therapy plays immense role in development of motor functions which can be improved best during the physical developmental and learning ability age of the child. Therefore, it is recommended to start neurodevelopmental therapy at a few weeks age of the child, and perform the neurosurgical procedure as soon as the child develops resistance to the therapy. The child has to resume back to therapy following the surgery for further motor development. There are various neurosurgical procedures for the relief of positive neurological phenomena. The present article includes brief description of the procedures and review of the literature. The authors feel that the selective posterior rhizotomy is perhaps the best procedure among all other ablative procedures for the relief of diffuse spasticity of both the lower limbs in strictly selected cases.