Pediatric Neuromuscular Care: Treating a Spectrum of Conditions

Cerebral Palsy

Cerebral palsy (CP) is a disorder that affects a child's ability to control their muscles. It is caused by damage or abnormalities in the parts of the brain that are involved with movement and coordination. The spinal cord and muscles in a child with CP are structurally normal they are just being constantly told to move or contract. This results in stiffness of joints and the inability to move normally. In most cases, cerebral palsy begins before a baby is born; however, CP can also begin at birth or during the first years of life. Early signs of CP include delays in meeting milestones, such as learning to roll over, sit, crawl, or walk. CP can be mild, moderate, or severe, depending on which part and how much of the brain is involved. Some children can walk independently, while others need assistive devices, like crutches or walkers and braces. Some children with CP require the use of wheelchairs for mobility.

In addition to affecting muscles and motor skills, CP may cause a range of other problems in children These include Mental impairment (such as intellectual disability or learning disability), Seizures, Vision difficulties, Shortened limbs, Curvature of the spine (scoliosis), and problems with joints (contractures, hip forced out of socket) Although there is no cure for CP, the disorder does not worsen as a child grows. Early treatment, such as physical therapy, medication, braces, and other assistive devices, can help children improve their function.

 

Muscular dystrophy in children: Descripción general

Finding out that your child has muscular dystrophy (MD) can be upsetting. You may be worried about your child's future. But many people with this disease live an active life.

There are several types of muscular dystrophy. Each type affects the body differently. Some types show up early, and others show up later. But all types are caused by inherited genes that weaken muscles. Your child's doctor may do tests to know what type your child has. These include genetic tests and a biopsy of your child's muscles.

The most common types of muscular dystrophy are:

  • Duchenne and Becker muscular dystrophies. Duchenne MD mostly affects boys starting at age 3 to 5. Boys with Duchenne MD may lose their ability to walk by age 12. Later in their life, they may also need a respirator to breathe. Becker MD usually starts later and tends to have less severe symptoms.
  • Facioscapulohumeral MD. This affects boys and girls and usually starts in the teen years. This type causes weakness in the face, arm, and leg muscles. This weakness may be mild or disabling.
  • Myotonic MD. This can affect boys and girls. The age it appears can vary depending on what form the child has. It causes muscle spasms that make it hard to relax. The muscles also weaken and get smaller. It can be mild or severe.

There are many treatments to help your child stay as active as possible. These include medicine, physical therapy, and devices to support the muscles. You can work with your doctor to make a treatment plan.

Marfan syndrome

Marfan syndrome is an inherited disorder that causes problems in the connective tissues of the blood vessels, heart, and eyes, and affects the muscles, ligaments, bones, and tendons. People with Marfan syndrome tend to be tall and thin with long arms, legs, fingers, and toes.

Marfan syndrome may cause heart or aorta problems, a curved spine, vision trouble, and pain if the nerves are affected. Some people may have mild problems. But others have more serious symptoms.

Treatment for Marfan syndrome includes treating specific problems related to the connective tissue disease, such as heart problems.

Osteogenesis imperfecta

Osteogenesis imperfecta is a group of rare disorders in which the bones are extremely fragile and break or fracture easily, often without apparent cause. The effects of the condition vary from case to case.

Treatment for osteogenesis imperfecta focuses on prevention of breaks and development of bone mass and strong muscles. Care may include assistive devices such as braces and wheelchairs.

Neuromuscular Programs at Renown Children's Hospital

Spasticity Management
  • Medical management (baclofen)
  • Botox clinic
  • Bracing
  • Assistive Devices
  • Fisioterapia
Neuromuscular Scoliosis
  • Bracing
  • Wheelchair modification
  • Growing Rods: VEPTR, Shilla, Magec
  • Spinal Fusion Instrumentation
Contractures & Hip Problems
  • Growth modulation
  • SEML (single event multiple level surgery)
  • Osteotomies