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Clinical Session Proposals

Pediatric Rehabilitation

Session Name: Concurrent Sessions

Advanced Hypertonia Management in Children: Who, What, When, and Why Not

Friday, November 17, 2023
9:15 AM – 10:30 AM CT
Location: CC 228-230
In-Person Live Stream On Demand

    Session Director(s)

  • Joline E. Brandenburg, MD (she/her/hers)

    Consultant, Assistant Professor
    Mayo Clinic of Rochester
    Mazeppa, Minnesota

    Disclosure(s): AACPDM: Officer or Board Member (Ongoing)

    • Faculty(s)

  • Marcie Ward, MD

    Pediatric Rehabilitation Medicine
    Gillette Children's Specialty Healthcare
    St Paul, Minnesota

    Disclosure(s): No financial relationships to disclose

  • Elizabeth Martin, MD, MPH

    Assistant Professor
    Vanderbilt University Medical Center
    Nashville, Tennessee

    Disclosure(s): No financial relationships to disclose

  • Rita Ayyangar, MD

    Professor, Clinical Track, Dept of PM&R, University of Michigan, Ann Arbor, MI
    University of Michigan
    Ann Arbor, Michigan

    Disclosure(s): No financial relationships to disclose

  • AB

    Angeline Bowman, MD (she/her/hers)

    Assistant Professor
    University of Michigan
    Bloomfield Hills, Michigan

    Disclosure(s): No financial relationships to disclose

Session Description: Advanced hypertonia management options in children and adolescents continues to evolve with new procedures emerging and well-established procedures expanding their indications. Data on long term outcomes in some advanced procedures are emerging. How does one navigate these options in clinical practice? In this course, we will have exert providers from differing institutions discuss selective dorsal rhizotomy, palliative rhizotomy (selective dorsal and ventral rhizotomy), intrathecal baclofen pumps, deep brain stimulation, and emerging interventions including hyperselective peripheral neurectomies.

Why is this session needed? : Not all academic and clinical institutions have availability of advanced hypertonia management for children and adolescents. In those that do, there may be inconsistency in clinical recommendations, varying opinions on best options creating confusion among families trying to decide what may be the best option for their child. Furthermore, as these procedures can impact lifelong hypertonia management, adult providers also need to be aware of these procedures.
In a combination of evidence and experience based-manner, we will discuss what the procedures are, who to consider, when to consider, potentially when not to do selective dorsal rhizotomy, palliative rhizotomy (selective dorsal and ventral rhizotomy), intrathecal baclofen pumps, deep brain stimulation, and emerging interventions including hyperselective peripheral neurectomies. When possible we will include any additional pearls, pitfalls, potential complications, and evidence on long-term outcomes of these procedures. We will then open up for a panel and audience discussion on experiences with these procedures along with opportunity for Question and Answer.

Was this session previously presented at the Annual Assembly?: No

Learning Objectives:

  • Describe which advanced hypertonia management options may be applicable to differing pediatric populations.
  • Discuss advanced hypertonia management options with their patients, including candidacy, risks, and benefits.
  • Recognize new and emerging advanced hypertonia management options.