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Neuropediatrics 2018; 49(01): 044-050
DOI: 10.1055/s-0037-1607395
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Risk Factors for Dystonia after Selective Dorsal Rhizotomy in Nonwalking Children and Adolescents with Bilateral Spasticity

Laura A. van de Pol
1   Department of Child Neurology, VU University Medical Center, Amsterdam, The Netherlands
,
R. Jeroen Vermeulen
2   Child Neurology, Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands
,
Charlotte van 't Westende
1   Department of Child Neurology, VU University Medical Center, Amsterdam, The Netherlands
,
Petra E.M. van Schie
3   Department of Rehabilitation Medicine, VU University Medical Center, Amsterdam Movement Sciences, Amsterdam, The Netherlands
,
Eline A.M. Bolster
3   Department of Rehabilitation Medicine, VU University Medical Center, Amsterdam Movement Sciences, Amsterdam, The Netherlands
,
Pim W.J.R. van Ouwerkerk
4   Department of Neurosurgery, VU University Medical Center, Amsterdam, The Netherlands
,
Rob L. Strijers
5   Department of Clinical Neurophysiology, VU University Medical Center, Amsterdam, The Netherlands
,
Jules G. Becher
3   Department of Rehabilitation Medicine, VU University Medical Center, Amsterdam Movement Sciences, Amsterdam, The Netherlands
,
Agnita Stadhouder
6   Department of Orthopaedic Surgery, VU University Medical Center, Amsterdam Movement Sciences, Amsterdam, The Netherlands
,
Pim de Graaf
7   Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands
,
Annemieke I. Buizer
3   Department of Rehabilitation Medicine, VU University Medical Center, Amsterdam Movement Sciences, Amsterdam, The Netherlands
› Author Affiliations
Further Information

Publication History

29 May 2017

18 September 2017

Publication Date:
07 November 2017 (online)

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Correction to:

Erratum: Risk Factors for Dystonia after Selective Dorsal Rhizotomy in Nonwalking Children and Adolescents with Bilateral SpasticityNeuropediatrics 2018; 49(01): e1-e1
DOI: 10.1055/s-0037-1613692

Abstract

We recently showed a beneficial effect of selective dorsal rhizotomy (SDR) on daily care and comfort in nonwalking children with severe bilateral spasticity. However, despite careful selection, some patients showed dystonia after the intervention, in which cases caregivers tended to be less satisfied with the result.

The aim of this study is to identify risk factors for dystonia after SDR in children and adolescents with severe bilateral spasticity (GMFCS levels IV/V).

Clinical and MRI risk factors for dystonia after SDR were studied in our cohort of 24 patients. Patients with clinical evidence of dystonia and brain MRI showing basal ganglia abnormalities were excluded for SDR.

Nine of 24 patients (38%) showed some degree of dystonia after SDR. There was a significant association between the cause of spasticity and dystonia after SDR; in six (67%) patients with a congenital disorder, dystonia was present versus three (20%) with an acquired disorder (Chi-squared test: C(1) = 5.23, p = 0.02).

This study allows more optimal selection of patients that may benefit from SDR. Patients with an acquired cause of spasticity, when selected carefully on clinical examination and MRI, rarely show dystonia after SDR. However, patients with an underlying congenital disorder have a considerable risk of dystonia after SDR.

Keywords

cerebral palsy - spasticity - SDR - intervention - dystonia - MRI

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.


Supplementary Material

 

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