- Changing incidence of spasticity in young children: There are suggestions at pediatric neurology meetings that fewer children with CP develop spasticity than 10-15 years ago because of changes in the neonatal intensive care management of premature children. Other manifestations of disorders of movement and posture (athetosis and dystonia) seem to be more prevalent. Other means of treatment for these movement disorders need to be developed. The surgical arm of such treatments would obviously be the development of protocols for childhood dystonia, reserving selective dorsal rhizotomies and baclofen pump implantation for those children still manifesting a predominance of spasticity.
- Mixed hypertonia and dystonia: A difficult group to manage is still patients with mixed spasticity and dystonia. The group in Egypt (37) have been performing combined anterior and posterior rhizotomy for these patients for a few years now. This may be something to evaluate in future in other centers as well
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