Suprasegmental Effects of Selective Posterior Rhizotomy
1 , 2Hořínek D., 1Tichý M., 3Černý R., 4Vlková J.
1Oddělení dětské neurochirurgie FNM, Praha 2Ústav patologické fyziologie 2. LF UK, Praha3Klinika neurologie dospělých – neuro-oftalmologická laboratoř 2. LF UK a FNM, Praha4Klinika rehabilitace 2. LF UK a FNM, Praha |
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Summary:
The occurrence of spasticity is most commonly attributed to the lack of presynaptic inhibition. Perinatal damage to
the central nervous system, as it happens in cerebral palsy, leads to pathological reflex response both on segmental
and polysegmental levels. It results not only in clinical signs typical for spasticity but also in alterations of brainstem
function, such as dysarthria or congenital nystagmus. Selective posterior rhizotomy is a neurosurgical method,
routinely used in the treatment of spasticity. The lumbosacral posterior roots are partially cut under perioperative
neurophysiological control. The aim of the treatment is the reduction of afferentation for posterior horns resulting
in a decrease of pathological reflex responses. Selective posterior rhizotomy consequently decreases lower limbs
spasticity. The improvement of upper extremities fine skills, the improvement of speech and cognitive functions has
been also observed after selective posterior rhizotomy. The possible pathophysiological explanations of these
so-called suprasegmental effects are discussed in the article.
Key words:
spasticity, central nervous system, selective posterior rhizotomy, suprasegmental effects.
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