Advances in cerebral palsy

Cerebral palsy is a broad term applied to a condition in which the patient has increased pyramidal (spasticity) and extrapyramidal (athetosis, dystonia, etc.) movement abnormalities. These upper-motor neuron abnormalities contribute to musculoskeletal abnormalities. The etiology and associated problems of cerebral palsy are reviewed. New interventional techniques addressing the movement problems such as botulinum toxin, selective dorsal rhizotomy, and intrathecal baclofen pump placement are discussed. There are limitations of the current evidence for nonoperative treatment such as physical therapy and hyperbaric oxygen treatment. Operative approaches devised to improve the function of children with cerebral palsy such as bony rotational osteotomies and soft-tissue surgery, as well as their limitations are stressed.