Case report shows selective rhizotomy improves motor function in a child with refractory dystonic status, indicating its viability in resource-limited settings.
Introduction/Background: Status dystonicus (SD) is a life-threatening neurological emergency, particularly in children with mixed-type cerebral palsy (CP), where dystonia and spasticity coexist. Although deep brain stimulation (DBS) is a recognized therapeutic option, its use in acute settings and resource-limited environments can be challenging. Case Presentation: We report the case of a 4-year-old boy with mixed CP secondary to traumatic brain injury, who developed refractory SD. The patient presented with severe dystonia, spasticity (Ashworth grade 3) and required intensive care due to rhabdomyolysis and autonomic instability. After failure of clinical management, a mixed selective rhizotomy (MVR) was performed as an emergency intervention. Conclusions: MVR resulted in immediate motor relief, full resolution of SD, and functional improvement of the upper limbs. This case highlights MVR as an effective, low-cost and viable alternative for controlling refractory SD in patients with mixed motor phenotypes, especially in resource-limited settings.
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Oliveira et al. (2025) studied this question.
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