About this topic
Children with cerebral palsy often have very stiff muscles. This is called spasticity. Your child may have muscle stiffness in the arms, legs, or trunk. Because of the muscle stiffness, your child may have problems with walking. The stiffness can limit how fast your child is able to walk and how well your child is able to move the legs. If the stiffness keeps up, it can lead to lasting muscle and bone problems. ‚
Muscles normally have some stiffness. This is called muscle tone. The muscles send signals through nerves to the spinal cord to keep up this tone. At the same time, the muscles also are getting signals to relax. These signals move from the brain through nerves to the spinal cord. With muscle spasms, the brain may not be able to send out enough signals to get the muscles to relax. Then, there is too much muscle tone or spasticity. ‚
Selective dorsal rhizotomy is also called SDR. It is one way to treat the muscle spasms. This surgery helps to balance the signals sent from nerves from the spinal cord to the muscles that give muscle tone. The doctor cuts some of the nerves that are in charge of muscle tone. This helps to balance the signals for tone and for relaxing. SDR helps to relax muscles. It may lower chronic pain in the arms or legs. SDR can also help to fix an overactive bladder. ‚
What care is needed at home?
- Ask your doctor what you need to do when you go home. Make sure you ask questions if you do not understand what the doctor says. This way you will know what you need to do to care for your child.
- Carefully follow the therapy program for your child. This is very important.
- Your child will tire easily.
- Your child may have muscle spasms while sleeping. Be sure to have a muscle relaxing drug on hand for your child.
- Your child may have a change in toilet habits for a short time. This is due to swelling and healing of the nerves that go to the bladder.
- You will need to learn proper ways to lift and move your child.
- Give your child a stool to support the feet while sitting.
- Encourage your child to be active. Offer time to play on the floor, sit, crawl, and kneel.
- Try having your child wear socks and shoes if your child feels new sensations on the feet.
- Reassure your child that progress takes time.
What follow-up care is needed?
- The doctor will ask you to make visits to the office to check on your childs progress. Be sure to keep these visits.
- Your child will have to see a physical therapist. The physical therapist will teach your child exercises to help your child get strength and motion.
What drugs may be needed?
The doctor may order drugs to: ‚
- Prevent infection
- Help with pain
- Ease muscle spasms
Will physical activity be limited?
- Your child may have to limit their activity. Talk to your doctor about the right amount of activity for your child.
- The SDR surgery will only help with the spasms. It does not fix any weakness, balance, or movement patterns that were there before.
What problems could happen?
- Infection
- Bleeding
- No change in muscle tone
- Nerve damage, such as change in toilet habits that does not go back to normal for your child
- New weakness in muscles
- Loss of feeling, numbness, or uncomfortable sensations in lower legs
When do I need to call the doctor?
- Signs of infection. These include a fever of 100.4 ‚ °F (38 ‚ °C) or higher, chills, cough, more sputum or change in color of sputum, pain with passing urine, wound that will not heal, or pain.
- Signs of wound infection. These include swelling, redness, warmth around the wound; too much pain when touched; yellowish, greenish, or bloody discharge; foul smell coming from the cut site; cut site opens up.
- Muscle spasms are too bad
- Your child is not making progress with therapy or has setbacks
- Signs of nerve damage, such as change in toilet habits that does not go back to normal for your child, new weakness in muscles, or loss of feeling that was not there before surgery
Teach Back: Helping You Understand
The Teach Back Method helps you understand the information we are giving you about your child. The idea is simple. After talking with the staff, tell them in your own words what you were just told. This helps to make sure the staff has covered each thing clearly. It also helps to explain things that may have been a bit confusing. Before going home, make sure you are able to do these: ‚
- I can tell you about my childs condition.
- I can tell you what may help ease my child's pain.
- I can tell you what I will do if my child has more muscle spasms or signs of nerve damage.
Where can I learn more?
National Institute of Neurological Disorders and Stroke ‚
http://www.ninds.nih.gov/disorders/cerebral_palsy/detail_cerebral_palsy.htm#179363104 ‚
Consumer Information Use and Disclaimer
This information is not specific medical advice and does not replace information you receive from your health care provider. This is only a brief summary of general information. It does NOT include all information about conditions, illnesses, injuries, tests, procedures, treatments, therapies, discharge instructions or life-style choices that may apply to you. You must talk with your health care provider for complete information about your health and treatment options. This information should not be used to decide whether or not to accept your health care providers advice, instructions or recommendations. Only your health care provider has the knowledge and training to provide advice that is right for you. ‚
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Copyright ‚ © 2015 Clinical Drug Information, LLC and Lexi-Comp, Inc. ‚