Treatment of Pediatric Movement Disorders

Surgery: Dorsal Rhizotomy

Because spasticity is probably due to increased activity in the stretch reflex, dorsal rhizotomy was developed to interrupt the nerves that bring spasticity impulses into the spinal cord. The nerves are exposed in the lumbar region of the lower back and separated into rootlets. The individual rootlets are electrically stimulated and the 30% to 50% of rootlets that give abnormal responses are then cut. This operation appears to permanently relieve spasticity in the legs and does not cause numbness or weakness. It is important to carefully select appropriate candidates for this surgery. In particular, rhizotomy is not helpful for children with dystonia or parkinsonian rigidity. Dystonia, rigidity, and spasticity must be correctly diagnosed to determine which children are likely to benefit from this procedure.

	Deep Brain Lesion