Showing a cerebral palsy child with severe crouch gait before and after surgery, with significant improvement in walking

Cerebral palsy (CP) is now the most common neuromuscular disorder in children. The advancement in ‘Mother and Child’ care in India there is increase in survival of preterm child. This increase in survival of preterm babies has led to increase in number of cerebral palsy patients. The cause of cerebral palsy is an insult in the pre/intra/post-partum period which causes decreases in oxygen to the brain and hence will cause a permanent, non-progressing damage to the child brain either in-utero or infancy.

Though the injury in the brain is non-progressive, the musculoskeletal complications as a result of the disease is progressive.

Diagnosis- MRI of the brain is the investigation of choice for diagnosis of the brain lesion. CP is one of the most complex condition in Pediatric orthopedics. A meticulous clinical evaluation, radiograph and gait (walking) evaluation is required for appropriate treatment and planning of surgery.

Treatment-

Physiotherapy is the mainstay of treatment. Improvement in the gait is the primary goal of treating physician.

Anti-spasmodic medication is used to decrease the overall spasm of the body.

Botox injections- local injection of Botox in the muscle temporarily decreases the spasm, this temporary period of relief gives us the opportunity to increase the rate and rhythm of physiotherapy.

Surgery- Single Event Multiple Level Surgery is now proposed as standard of care in Cerebral Palsy.