Initial Management at Presentation
- Physical examination of tone: Any management plan must begin with examination of the patient so that the type of hypertonia present is understood.
- Confirmation that tone is problematic: Next, a discussion occurs with treating therapists to confirm that the tone is problematic with regard to motor development and the therapy being given to foster motor development.
- Select surgery based on type of tone: The most appropriate surgery is then selected based on the type of hypertonia and its distribution.
Neurosurgical Procedures for Hypertonia
- Selective dorsal rhizotomy
- Intrathecal baclofen
- Selective neurectomy
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