What is the key to cerebral palsy treatment?

  Generally speaking, medications have little or no effect on the treatment of pediatric cerebral palsy. However, if a child with cerebral palsy has seizures, they can be controlled with anti-epileptic drugs. The real scientific and effective treatment for cerebral palsy should be rehabilitation combined with surgery. For example, spastic cerebral palsy is the most common type of cerebral palsy in clinical practice. The main manifestation of this type is tiptoe and scissor gait, in other words, the child cannot walk like a normal person.  As we know, the ability of normal people to move flexibly and maintain their posture is the result of a proper extension reflex. If the reflex contraction of the muscles is too strong during extension, the movement is limited and the range of motion of the joints is narrowed, giving the impression of spastic stiffness. Patients with spastic cerebral palsy have hyperactive extensor reflexes when performing passive joint movements, and are unable to respond well to motor commands from the brain, resulting in impaired movement and abnormal posture.  To improve walking function, children with spastic cerebral palsy should undergo active rehabilitation at an early stage; targeted rehabilitation techniques can also be used to correct contractures (lengthening of shortened tendons) or to reduce the tension of spastic muscles to prevent contractures from occurring. In case of poor results or recurrence of the condition, surgical treatment should be performed promptly in order to release the excessive muscle tone as early as possible, surgically release the spasticity, and perform the necessary deformity correction.  In other words, based on the preliminary rehabilitation training, as long as the child with spastic cerebral palsy meets the requirements of simple spasticity, muscle tone above grade 3 and muscle strength above grade IV; no obvious fixed contracture deformity or only mild deformity; certain motor ability of the spinal limbs before surgery; normal or near-normal intelligence, able to cooperate with postoperative rehabilitation training; severe spasticity and rigidity, affecting daily life, care and rehabilitation training, etc. For those who have severe spasticity and stiffness that interferes with daily life, care and rehabilitation, it is advisable to perform the decompression surgery between the ages of 2.5 and 6 years.  The FSPR technique is based on positioning, and the type and number of nerves to be cut are monitored and analyzed by a multi-conductor electrophysiological monitor, which overcomes the subjective factors of traditional SPR and allows for the quantification of the proportion of nerves to be cut, resulting in more precise and accurate surgery and avoiding complications such as medically induced paralysis and urinary and fecal incontinence.  However, it should be noted that although phase I surgery for cerebral palsy is unique in relieving muscle spasticity, it is difficult to correct joint deformation and soft tissue contracture. This includes selective narrowing of the peripheral nerves, tendon severing and lengthening of the joint capsule, joint fusion or osteotomy, etc., in order to receive the best treatment effect.  We have seen a 4-year-old patient with spastic cerebral palsy caused by a difficult birth, who could not stand, could not walk, had limited ankle movement, and showed foot drop and scissor gait. She received FSPR treatment along with the rehabilitation training, and her original foot drop and scissor gait were basically corrected by 15 days in the hospital, and by 45 days of treatment, she could walk 300 meters and do squatting independently.  While we insist on scientific treatment of cerebral palsy, we should also pay attention to minimizing the incidence of cerebral palsy. Generally speaking, neonatal asphyxia, hypoxic-ischemic encephalopathy and birth injury may lead to progressive brain defects or injuries, which may then cause central movement disorders and eventually lead to pediatric cerebral palsy, and this must be taken seriously enough.