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Nonsurgical treatment of spastic hemiparesis

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Cerebral palsy requires a multidisciplinary management: orthopedic surgeons, occupational therapist, physical therapist, neurologist and nutritionist.

Treatments can be manifold: physical therapy, botulinum toxin, surgery, etc.

The patient should be assessed multiple times before making a decision.

Occupational Therapy and Physiotherapy

Occupational therapy and physiotherapy are essential. Occupational therapy aims to help develop techniques to improve the performance of daily living activities (eg, tying shoelaces) (Figure 7).


Figure 7. Exercises to improve manual dexterity.

Physical therapy uses passive exercises of the joints and splints or braces to prevent muscles from shortening (Figure 8).


Figure 8. Splint to keep the thumb abducted and wrist extension.

Botulinum Toxin

Botulinum toxin is a medication that is injected into the muscle, in order to relax it. It applies to spastic muscles (tense). Its effect lasts for 4 -6 months. After multiple punctures, this treatment may no longer be effective. Treatment is often used in early ages, less than 8 years old, before surgery.

We use Xeomin ® because it offers many advantages (Figure 9).

Figure 9. Xeomin ®

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