Artikel
Suprasegmental effects of selective posterior rhizotomy
Suprasegmentale Effekte der selektiven hinteren Rhizotomie
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Veröffentlicht: | 30. Mai 2008 |
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Gliederung
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Objective: Beside the intrathecal Baclofen, selective posterior rhizotomy (SPR) still represents an effective and valuable tool in the reduction of severe spasticity in children with cerebral palsy (CP). Along with the decrease of spasticity in legs, the improvement of fine motor skills has been observed in patients after SPR. The aims of this study were to demonstrate the improvement of speech fluency and eye movements in children with CP.
Methods: 25 children with CP (16 boys, 9 girls; age 13,2±4,7) and severe spasticity underwent SPR. In all children Ashworth scale was performed to assess the severity of spasticity pre- and postoperatively.
An acoustic analysis was carried out to determine the changes in speech fluency in 13 patients. Standard deviation of fundamental frequency of voice, shimmer and jitter were the parameters of measure of voice quality. Video-oculography was used for pursuit eye movement registration in 7 patients.
Results: Spasticity was reduced markedly both in upper and lower extremities (p<0,001). The parameters of speech fluency improved significantly after surgery (p<0,05). 4 from seven subjects manifested a decrease of spontaneous nystagmus on pursuit eye movement analysis.
Conclusions: We were able to demonstrate the improvement of speech fluency and decrease of spontaneous nystagmus after SPR. These suprasegmental effects may be interpreted as the decrease of pathological reflex response on higher anatomical levels including brainstem and cerebral cortex. Suprasegmental effects may be beneficial for the quality of life of children undergoing SPR.
The project has been supported by IGA grant NR-8848