We offer individualized procedures and other treatment options for cerebral palsy based on the child's specific needs and goals. Considerations include your child's type of CP, which parts of the body are affected, functional level and your family's goals. Most children benefit from a combination of therapies.
Nonsurgical treatment options for cerebral palsy
Therapy and rehabilitation: Physical therapy, occupational therapy, and speech therapy form the backbone of CP treatment. Therapies focus on building strength, improving coordination, managing tone, and developing communication and feeding skills.
Assistive devices: Braces (orthotics), walkers, gait trainers, custom wheelchairs, standers, and communication devices help children participate more fully in daily life.
Medications: Oral medications can help reduce muscle tone (such as baclofen or diazepam), manage seizures, or treat pain. Injectable medications like botulinum toxin and phenol can temporarily relax specific muscles.
Injectable medications (such as botulinum toxin and phenol) to relax specific muscles
Nutritional counseling
Communication aids
Neurosurgical procedures for cerebral palsy
Some children with cerebral palsy benefit from neurosurgical procedures to reduce abnormal muscle tone or orthopedic procedures to address musculoskeletal problems that develop over time. Surgical decisions are made together with the full care team and your family, based on your child's functional level, symptoms, and goals.
These neurosurgical procedures reduce spasticity or dystonia by changing the signals between the brain, spinal cord and muscles. The goal is to reduce abnormal tightness so that therapy, bracing and daily activities become more effective.
Selective dorsal rhizotomy (SDR) permanently reduces spasticity in the legs by cutting specific sensory nerve roots in the lower spine. Texas Children's also performs a focal selective technique that targets individual muscle groups for children who need treatment in one area of the body. Palliative rhizotomy benefits children with severe muscle tone that affects comfort, positioning, daily care and physical movement.
Intrathecal baclofen therapy uses a small surgically implanted pump to deliver muscle-relaxing medication directly to the fluid surrounding the spinal cord. It can reduce spasticity throughout the body and is adjustable over time.
DBS is a surgical treatment for dystonia, which causes involuntary muscle contractions and abnormal postures. Many children with cerebral palsy have dystonia along with spasticity. A surgeon places thin electrodes in a specific area of the brain and connects them to a small pulse generator in the chest or abdomen. The device sends continuous electrical signals that reduce the dystonia. Results develop gradually over weeks to months as the settings are adjusted.
A neurectomy partially cuts a motor nerve to permanently weaken its signal to a specific overactive muscle. It is most useful when spasticity is very focal, such as in the elbow flexors, wrist flexors or calf muscle on one side.
Musculoskeletal problems develop over time as tight muscles pull bones out of alignment, limit joint motion and cause pain. Surgery is performed to reduce high muscle tone, lengthen muscles, and/or realign bones or correct spinal deformity.
Some children undergo multiple procedures during a single operation, known as single-event multilevel surgery (SEMLS), which can reduce the overall number of surgeries and recovery periods.
Common orthopedic procedures for children with CP include:
Muscle and tendon lengthening: releasing or lengthening muscles and tendons that have become too tight and are restricting movement or causing deformity
Tendon transfers: moving the attachment point of a tendon to change the direction of muscle pull and improve function
Osteotomies and hip reconstruction: cutting and repositioning bones to correct alignment, including hip reconstruction for children whose hip joint is displacing or dislocating due to muscle imbalance
Spinal fusion for scoliosis correction: procedures to straighten or stabilize the spine in children who develop curvature related to their CP
