Familial spastic paraparesis


Familial Spastic Paraparesis: At first glance, one might assume this patient has spastic diplegic cerebral palsy. However, this boy has a strong family history of spastic paraparesis. He has significant spasticity that was leading to the development of multiple contractures and torsional deformities. The patient had received botulinum toxin injections into his hamstrings and gastrocnemius muscle bilaterally with some effect; however, he still had problems with spasticity. As a result, it was felt that he was an appropriate candidate for a trial of intrathecal baclofen (ITB). He subsequently responded well to ITB. An intrathecal baclofen pump was then placed. The patient also had derotational osteotomies to correct his torsional deformities. The family and the patient felt that he was much more efficient in his ambulation with intrathecal baclofen. Although the patient’s gait did not change dramatically, his comfort in walking and his general confidence in performing gross motor skills activity improved.