1. Dyskinetic Cerebral Palsy
Greater Manchester Cerebral Palsy Network Meeting
7th November 2013
Dr Martin Smith
Consultant Paediatric Neurologist
Birmingham Children’s Hospital

2. Athetosis Chorea Dystonia Unsustained; flowing Intermittent; irregular
Sustained postures

3. Abnormal
(usually high)
muscle tone
Weakness
Impaired motor control

4. Dystonia Involuntary sustained or intermittent muscle contractions cause twisting and repetitive movements, and/or abnormal postures ‘Inserted postures and movements’

5. Chorea
Greek, khoreia, meaning dance
Involuntary, random (appearing), quick jerking movements
Abrupt, non-repetitive and arrthymic
Variable frequency and intensity

6. Athetosis
Described by Hammond (1871) as “an inability to retain the fingers and toes in any position they might be placed, and by their continual motion”
Hyperkinetic movement disorder characterised by involuntary writhing movements of the distal extremities and peri-oral muscles
Some consider athetosis as a variant of dystonia

7. Symmetrical high signal in ventro-lateral thalamus and putamen following acute near total hypoxic-ischaemic injury in term infant

8. Treatments
Orthosis e.g. lycra, second skin etc
Medication for dystonia e.g. Trihexiphenidyl, Clonidine, L-Dopa
Medication for chorea e.g. Levitarecetam, Valproate, Tetrabenzine
Intra-thecal Baclofen
Deep brain stimulation
Stem cells ???

9. Thanks to Birmingham colleagues past and present
Thanks to children and families for allowing me to use videos for teaching and education
Thanks to Birmingham colleagues past and present
Dr Hardev Pall
Dr Manju Kurian
Dr Stuart Green