Neurosurgical options in cerebral palsy

The main movement disorders in cerebral palsy (CP) are spasticity, dystonia, athetosis and chorea. Their neurosurgical treatments have improved dramatically in the past two decades. Focal spasticity can now be effectively treated with peripheral selective neurectomies, spastic diplegia with lumbar dorsal rhizotomies, and generalized spasticity with continuous intrathecal baclofen (ITB) infusion. Dystonic CP is usually generalized and can be treated with ITB; refractory cases may respond to deep brain stimulation. There are presently no effective neurosurgical options for athetosis, although deep brain stimulation shows promise for choreiform CP.