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Monbaliu E, Himmelmann K, Lin JP, et al. Clinical presentation and management of dyskinetic cerebral palsy. Lancet Neurol. 2017;16(9):741-749doi: 10.1016/S1474-4422(17)30252-1.
Monbaliu, E., Himmelmann, K., Lin, J. P., Ortibus, E., Bonouvrié, L., Feys, H., Vermeulen, R. J., & Dan, B. (2017). Clinical presentation and management of dyskinetic cerebral palsy. The Lancet. Neurology, 16(9), 741-749. https://doi.org/10.1016/S1474-4422(17)30252-1
Monbaliu, Elegast, et al. "Clinical presentation and management of dyskinetic cerebral palsy." The Lancet. Neurology vol. 16,9 (2017): 741-749. doi: https://doi.org/10.1016/S1474-4422(17)30252-1
Monbaliu E, Himmelmann K, Lin JP, Ortibus E, Bonouvrié L, Feys H, Vermeulen RJ, Dan B. Clinical presentation and management of dyskinetic cerebral palsy. Lancet Neurol. 2017 Sep;16(9):741-749. doi: 10.1016/S1474-4422(17)30252-1. PMID: 28816119.
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Lancet Neurol. 2017 Sep;16(9):741-749. doi: 10.1016/S1474-4422(17)30252-1.

Clinical presentation and management of dyskinetic cerebral palsy.

The Lancet. Neurology

Elegast Monbaliu, Kate Himmelmann, Jean-Pierre Lin, Els Ortibus, Laura Bonouvrié, Hilde Feys, R Jeroen Vermeulen, Bernard Dan

Affiliations

  1. Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium; Dominiek Savio Instituut, Gits, Belgium.
  2. Department of Pediatrics, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
  3. Evelina Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, King's Health Partners, London, UK.
  4. Department of Development and Regeneration, KU Leuven, Leuven, Belgium.
  5. Department of Rehabilitation Medicine, VU University Medical Center Amsterdam, Amsterdam, Netherlands.
  6. Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium.
  7. Department of Neurology, Maastricht University Medical Center, Maastricht, Netherlands.
  8. Department of Neurology, Université Libre de Bruxelles, Brussels, Belgium; Inkendaal Rehabilitation Hospital, Vlezenbeek, Belgium. Electronic address: [email protected].

PMID: 28816119 DOI: 10.1016/S1474-4422(17)30252-1

Abstract

Cerebral palsy is the most frequent cause of severe physical disability in childhood. Dyskinetic cerebral palsy (DCP) is the second most common type of cerebral palsy after spastic forms. DCP is typically caused by non-progressive lesions to the basal ganglia or thalamus, or both, and is characterised by abnormal postures or movements associated with impaired tone regulation or movement coordination. In DCP, two major movement disorders, dystonia and choreoathetosis, are present together most of the time. Dystonia is often more pronounced and severe than choreoathetosis, with a major effect on daily activity, quality of life, and societal participation. The pathophysiology of both movement disorders is largely unknown. Some emerging hypotheses are an imbalance between indirect and direct basal ganglia pathways, disturbed sensory processing, and impaired plasticity in the basal ganglia. Rehabilitation strategies are typically multidisciplinary. Use of oral drugs to provide symptomatic relief of the movement disorders is limited by adverse effects and the scarcity of evidence that the drugs are effective. Neuromodulation interventions, such as intrathecal baclofen and deep brain stimulation, are promising options.

Copyright © 2017 Elsevier Ltd. All rights reserved.

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