Surgical Tone Management Clinic

Hypertonia is a condition that causes abnormally increased muscle tone resulting in stiff muscles that are difficult to move due to either spasticity or dystonia. Hypertonia is common in individuals with cerebral palsy but can occur in a variety of conditions.

• Spasticity causes a relatively consistent increase in muscle tightness caused by dysfunction of the brain and/or spinal cord. Spasticity can also be associated with tremulousness of the limbs (clonus) and increased reflexes.
• Dystonia typically causes the body to adopt characteristic postures. Dystonia is often more variable than spasticity and often causes discomfort.

Both spasticity and dystonia can lead to “wear and tear” injury that impacts the muscles and soft tissues over time, leading to problems with a person’s hips, spine, and joints.

What to Expect

Your child’s first appointment will include a comprehensive evaluation by a team of pediatric experts, including physical medicine & rehabilitation (PM&R) doctors, neurosurgeons, movement disorders neurologists and orthopedic surgeons. The team will:

• Consider your child’s specific needs from their areas of expertise
• Provide a unified treatment plan that addresses your child’s unique needs
• Discuss their care recommendations with you and answer your questions

Treatment options for children with high muscle tone may include:

• Physical therapy
• Occupational therapy
• Injection therapy, including botulism toxin and phenol injections. Injections can be done in clinic without sedation, with light sedation in the clinic setting or under full anesthesia in the operating room.
• Surgery, such as:
  • Selective dorsal rhizotomy (SDR)
  • Intrathecal baclofen (ITB) pump implantation
  • Deep brain stimulation (DBS)
  • Orthopedic surgery

The care team may recommend a gait analysis as part of the comprehensive evaluation. The Bubba Watson and PING Golf Motion Analysis Laboratory at Phoenix Children’s (also referred to as the “Gait Lab”) uses state-of-the-art equipment to evaluate your child’s walking patterns and muscular activity. The results will help your child’s care team develop the most effective treatment plan possible.