Cerebral Palsy and Movement Disorders Clinic
Nicklaus Children’s Hospital, formerly Miami Children’s Hospital, offers a multidisciplinary approach to the evaluation and treatment of children with spasticity and movement disorders. The goal is to maximize movement, comfort and quality of life for affected children and their families. The Spasticity and Movement Disorders Clinic brings together a multispecialty care team that works to determine the best care options for each individual child.
During clinic visits, patients are seen by specialists in neurology, neurosurgery, orthopedics, physiatry and physical/occupational therapy. Specialists meet after each clinic and discuss every case individually. The clinical coordinator reaches out to the family to review treatment recommendations and schedule specific interventions.
The program, is one of the few in the nation that offers placement of deep brain stimulators to help children with movement disorders.
Conditions we treat
- Spasticity: This refers to the stiffness of muscles or resistance to stretching that interferes with normal movement.
- Dystonia: This refers to abnormal body movements or postures such as twisting that interfere with normal movement and coordination.
These conditions occur as a result of any damage within the central nervous system that impairs the coordination of muscle activity. It is most commonly related to:
- Cerebral palsy from birth-related complications
- Genetic conditions
The Spasticity and Movement Disorders Clinic offers a variety of treatments options to manage spasticity, including oral medications, Botox injections, Intrathecal baclofen trials as well as pumps and selective dorsal rhizotomy.
For dystonia, we offer oral medications, Botox injections and placement of a deep brain stimulator, an implantable device that sends electrical impulses to help with the management of movement and other neurological disorders.
Patients may also need orthopedic surgery to correct bone deformities or lengthen tendons.
Treatments options are individualized to each patient depending on the cause of the condition, age, general health and nutritional status as well as goals of treatment.
Intrathecal Baclofen pump therapy consists of the administration of continuous intrathecal Baclofen via an implanted, programmable pump. Refills of the baclofen medication are required at regular intervals based on the individual patient’s needs to ensure a continuous supply of the medication. This treatment can be a good option for patients whose arms are more affected than their legs, or have a combination of spasticity and other movement disorders such as dystonia.
A selective dorsal rhizotomy is another treatment option to relieve spasticity. The sensory nerve bundles that are the most abnormal are selectively cut to help alleviate the spasticity. This can help patients who walk using assistive devices to improve walking ability. It can also be considered for other patients who have significant pain related to their spasticity as a “palliative” option. Patients need intensive rehabilitation after the surgery to achieve the best outcomes.
Deep brain stimulation is an option for patients who suffer from movement disorders such as dystonia. It is a neurosurgical procedure involving the implantation of a “brain pacemaker” that sends electrical impulses, via implanted electrodes to specific parts of the brain for treatment of movement disorders.