Cerebellar stimulation for cerebral palsy spasticity, function, and seizures

Chronic cerebellar stimulation (CCS) applied to the superio-medial cortex r educes generalized cerebral spasticity, athetoid movements, and seizures. E ighteen clinics have reported on 600 cerebral palsy (CP) patients who compr ise 90% of those treated with CCS. CP patients have varying degrees of limi ted abilities interfered with by spasticity (primitive reflexes, increased muscle tone, co-contractions, and spasms) and by athetoid movements in two- thirds of the patients. With CCS, spasticity reduction occurred in 85% (mar ked 25%, moderate 34%, mild 27%) and resulted in improvements in patient dr ooling, speech, respiration, posture, motes performance, gait, joint range of motion, and mood states. Radiofrequency CRF)-linked stimulators were use d initially with serious equipment and calibration problems; 68% of 422 pat ients improved. When totally implantable controlled-current stimulators wer e used, 86% of 178 patients improved. Our double-blind study of 20 CP patie nts using this implantable stimulator showed 12 (60%) improved in motor per formance, joint range of motion, and profile of mood states when the stimul ator was ON. When abilities are graded (1: poor to 9. best), the seven pati ents with the higher functioning grades (5-8) all improved (99% confidence level). intractable seizures occurred in 27 (8%) of our CP patients. At a 1 7-year follow-up, 19 patients contacted were using or had used CCS with 10 (53%) seizure-free and 6 (32%) with reduced seizures. CCS should be given b y a totally implanted controlled-current stimulator (1-4 mu Coulombs/sq. cm . /phase, 150-200 Hz) applied intermittently to the superio-medial cerebell ar cortex for safe, effective, and continuous results. (C) 2000 IMSS. Publi shed by Elsevier Science Inc.