[Neurosurgery of the spasticity syndrome in children cerebral palsy].

The review is devoted to main neurosurgical approaches to the treatment of the spasticity syndrome in children cerebral palsy. Neurosurgical procedures are divided into destructive and neuromodulating. The former included posterior selective rhizotomy, selective neurotomy and destructive operations on subcortical brain structures. The latter group included electrostimulation of brain and spinal cord structures and implantation of pumps for the chronic intrathecal baclofen (lioresal) infusion. Each method is considered in a historical aspect. Details of clinical application, positive and negative sides of the methods are described.

[The use of chronic epidural electrostimulation of the spinal cord in children with spastic diplegia--a type of infantile cerebral palsy]. / Primenenie khronicheskoi épidural'noi élektrostimuliatsii spinnogo mozga u detei s detskim tserebral'nym paralichom v forme spasticheskoi displegii.

The authors' first experience with spinal cord stimulation (SCS) at the lumbar level in the treatment of cerebral palsies (CP) in children aged 3-11 years who had lower spastic paraparesis of varying severity is presented. Complex clinical and physiological studies of all 9 children were made before and after surgery (follow-ups lasting 6-12 months). Preliminary results have indicated that the most significant changes occur primarily in pathological postural tonic reflexes. SCS has virtually no effect on fixed limb deformities, which requires further orthopedic surgical correction. A medical care schedule for CP children affected predominantly with lower spastic paraparesis should include, among its first priorities, electrode implantation for SCS. Due to the specific rehabilitative dynamics of motor functions, SCS should be made to treat these children before the deformities in the lower extremity joints get fixed.