Interpretation on 2024 “Pharmacological and neurosurgical management of cerebral palsy and dystonia： Clinical practice guideline update”

doi:10.3877/cma.j.issn.2095-123X.2025.01.002

Abstract

Abstract:

The typical characteristics of dystonia are slow involuntary movements， abnormal postures， and muscle tone fluctuations， which are common in children with cerebral palsy and have a significant impact on motor function， pain， sleep， and home care. Due to its complex etiology， there is currently no specific treatment method available. Drug and neurosurgical interventions are important treatment methods for improving muscle tone disorders， but their evidence-based basis is limited and lacks clinical application standards. In March 2024， an international expert group consisting of 10 research centers from 6 countries released the “Pharmacological and neurosurgical management of cerebral palsy and dystonia： Clinical practice guideline update”， which updated and supplemented the intervention recommendations published in 2018. It proposed 10 evidence-based recommendations for drug treatment and neurosurgical intervention in patients with cerebral palsy and Muscular Dysfunction to guide clinical application decision-making. This article interprets the key content of this guideline in conjunction with the consensus of Chinese experts in the diagnosis and treatment of muscle tone disorders， in order to provide guidance and reference for the treatment of cerebral palsy and muscle tone disorders in China.

Key words: Cerebral palsy, Dystonia, Pharmacology, Intrathecal baclofen, Deep brain stimulation

Beibei Kang, Qiang Yu, Lei Xu, Rong Chen, Liu Wang, Jianguo Cao. Interpretation on 2024 “Pharmacological and neurosurgical management of cerebral palsy and dystonia： Clinical practice guideline update”[J]. Chinese Journal of Brain Diseases and Rehabilitation(Electronic Edition), 2025, 15(01): 10-14.

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［1］	中华医学会神经病学分会，中华医学会神经病学分会帕金森病及运动障碍学组. 肌张力障碍诊断中国专家共识［J］. 中华神经科杂志， 2020， 53（1）： 8-12. DOI： 10.3760/cma.j.issn.1006-7876.2020.01.003.Chinese Society of Neurology； Chinese Society of Parkinson's Disease and Movement Disorders. Chinese expert consensus on the diagnosis of dystonia［J］. Chine J Neurol， 2020， 53（1）： 8-12. DOI：10.3760/cma.j.issn.1006-7876.2020.01.003.
［2］	Fehlings D， Brown L， Harvey A， et al. Pharmacological and neurosurgical interventions for managing dystonia in cerebral palsy： a systematic review［J］. Dev Med Child Neurol， 2018， 60（4）：356-366. DOI： 10.1111/dmcn.13652.
［3］	Albanese A， Bhatia K， Bressman SB， et al. Phenomenology and classification of dystonia： a consensus update［J］. Mov Disord， 2013，28（7）： 863-873. DOI： 10.1002/mds.25475.
［4］	中华医学会神经病学分会帕金森病及运动障碍学组，中华医学会神经外科学分会功能神经外科学组，中国神经科学学会神经毒素分会，等. 肌张力障碍治疗中国专家共识［J］. 中华神经科杂志， 2020， 53（11）： 868-874. DOI： 10.3760/cma.j.cn113694-20200531-00404.Chinese Society of Parkinson's Disease and Movement Disorders；Chinese Society of Funtional Neurosurgery； The Neurotoxin Branch of Chinese Neuroscience Society， et al. Chinese expert consensus on the treatment of dystonia［J］. Chin J Neurol， 2020， 53（11）： 868-874. DOI： 10.3760/cma.j.cn113694-20200531-00404.
［5］	Fehlings D， Agnew B， Gimeno H， et al. Pharmacological and neurosurgical management of cerebral palsy and dystonia： clinical practice guideline update［J］. Dev Med Child Neurol， 2024， 66（9）：1133-1147. DOI： 10.1111/dmcn.15921.
［6］	中华医学会儿科学分会康复学组. 儿童肌张力障碍临床康复实践中国专家共识［J］. 中国实用儿科杂志， 2023， 38（1）： 1-15.DOI： 10.19538/j.ek2023010601.Rehabilitation Group， Chinese Pediatric Society， Chinese Medical Association. Chinese expert consensus on clinical rehabilitation practice in childhood dystonia［J］. Chin J Pract Pediatr， 2023， 38（1）： 1-15. DOI： 10.19538/j.ek2023010601.
［7］	Abdelmageed S， Horak VJ， Mossner J， et al. Safety and efficacy of intrathecal baclofen trials for the treatment of hypertonia： a retrospective cohort study［J］. J Neurosurg Pediatr， 2024， 33（2）：179-184. DOI： 10.3171/2023.11.Peds23473.
［8］	Oleárová A. Anticholinergic agents used in overactive bladder and their effect on cognitive function in elderly［J］. Klin Farmakol Farm， 2020， 34（1）： 34-37. DOI： 10.36290/far.2020.009.
［9］	Laurencin C， Timestit N， Marques A， et al. Efficacy and safety of clonidine for the treatment of impulse control disorder in Parkinson's disease： a multicenter， parallel， randomised， double-blind， phase 2b clinical trial［J］. J Neurol， 2023， 270（10）： 4851-4859. DOI： 10.1007/s00415-023-11814-y.
［10］	Tedeschi A， Larson MJE， Zouridakis A， et al. Harnessing cortical plasticity via gabapentinoid administration promotes recovery after stroke［J］. Brain， 2022， 145（7）： 2378-2393. DOI： 10.1093/brain/awac103.
［11］	Fairhurst C， Kumar R， Checketts D， et al. Efficacy and safety of nabiximols cannabinoid medicine for paediatric spasticity in cerebral palsy or traumatic brain injury： a randomized controlled trial［J］. Dev Med Child Neurol， 2020， 62（9）： 1031-1039. DOI： 10.1111/dmcn.14548.
［12］	Comella C， Ferreira J， Azoulai M， et al. Patient perspectives on the impact of cervical dystonia （CD） and botulinum neurotoxin type a （BoNT-A） treatment on work［J］. Value in Health， 2020， 23（S1）： S280. DOI： 10.1016/j.jval.2020.04.999.
［13］	党圆圆，赵虎林. 机器人辅助小脑齿状核脑深部电刺激植入术［J］. 中华脑科疾病与康复杂志（电子版）， 2023， 13（5）： 320. DOI：10.3877/cma.j.issn.2095-123X.2023.05.011.Dang YY， Zhao HL. Robot assisted deep brain stimulation implantation surgery in the cerebellar dentate nucleus［J］. Chin J Brain Dis Rehabil （Electronic Edition）， 2023， 13（5）： 320. DOI：10.3877/cma.j.issn.2095-123X.2023.05.011.

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