The gospel for cerebral palsy patients: robotic stereotactic neurosurgery

Cerebral Palsy in Children

Cerebral palsy in children, also known as infantile cerebral palsy or simply CP, refers to a syndrome primarily characterized by motor function impairments in posture and movement, resulting from non-progressive brain injury occurring within one month after birth when the brain is not yet fully developed. It is a common central nervous system disorder in childhood, with lesions primarily located in the brain and affecting the limbs. It is often accompanied by intellectual disability, epilepsy, behavioral abnormalities, mental disorders, as well as symptoms related to vision, hearing, and language impairments.

The Main Factors Leading to Cerebral Palsy

Six major causes of cerebral palsy： hypoxia and asphyxia, brain injury, developmental disorders, genetic factors, maternal factors, pregnancy changes

Intervention

Most cerebral palsy patients' primary symptom is limited mobility. The most pressing concern for parents of affected children is how to assist in their physical rehabilitation, enabling them to return to school and reintegrate into society as soon as possible. So, how can we enhance the motor skills of children with cerebral palsy?

Rehabilitation Training

The rehabilitation treatment of cerebral palsy is a long-term process. Generally, children should start rehabilitation therapy at around 3 months old, and consistently continuing for about a year usually yields noticeable effects. If a child undergoes a year of rehabilitation therapy and experiences relief from muscle stiffness, with walking posture and independent movement abilities similar to those of their peers, it indicates that the rehabilitation therapy has been relatively effective.

Treating cerebral palsy requires a variety of methods. Typically, children under the age of 2 only undergo rehabilitation therapy. If after a year the results are average or symptoms worsen, such as limb paralysis, increased muscle tone, muscle spasms, or motor dysfunction, early consideration of surgery is necessary.

Surgical Treatment

Stereotactic neurosurgery can address limb paralysis issues that cannot be improved solely through rehabilitation training. Many children with spastic cerebral palsy often experience prolonged periods of high muscle tension, leading to tendon shortening and joint contracture deformities. They may frequently walk on tiptoes, and in severe cases, experience bilateral lower limb paralysis or hemiplegia. In such cases, the treatment focus should involve a comprehensive approach combining stereotactic neurosurgery with rehabilitation. Surgical treatment not only improves motor impairment symptoms but also lays a solid foundation for rehabilitation training. Post-operative rehabilitation further consolidates the effects of surgery, promotes the recovery of various motor functions, and ultimately achieves the long-term goal of improving quality of life.

Case 1

Preoperative

High muscle tone in both lower limbs, unable to stand independently, unable to walk independently, weak lower back strength, unstable sitting posture, scissoring gait with assistance, knee flexion, tiptoe walking.

Postoperative

Lower limb muscle tone decreased, increased lower back strength compared to before, improved stability while sitting independently, some improvement in tiptoe walking.

Case 2

Preoperative

The child has intellectual disability, weak lower back, unable to stand or walk independently, high muscle tone in the lower limbs, and tight adductor muscles, resulting in a scissoring gait when assisted to walk.

Postoperative

Intelligence has improved compared to before, muscle tone has decreased, and lower back strength has increased, now able to stand independently for five to six minutes.

Case 3

Preoperative

The patient is unable to walk independently, walking on tiptoes with both feet, able to hold light objects with both hands, and has low muscle strength.

Postoperative

The grip strength of both hands is stronger than before. The patient can now turn over independently and place both feet flat, sit up by themselves, and stand up independently.

Case 4

Preoperative

Weak lower back strength, high muscle tone in both lower limbs, and when assisted to stand, the lower limbs cross and the feet overlap.

Postoperative

Lower back strength has improved slightly, muscle tone in the lower limbs has decreased somewhat, and there is an improvement in the tiptoe walking gait.