Many cerebral palsy handicapped people complain of the symptoms originating from dystonic and athetoid neck movements. Some of them complain of pain in the neck, or upper extremities. Some develop cervical myelopathy, however the diagnosis is frequently delayed because the early symptoms are vague and progression may be slow and intermittent.
We recently encountered two patients with mixed type of cerebral palsy in whom symptoms of cervical myelopathy have developed. Both of them were young, and were independent social ambulator before present onset. They became unable to walk by themselves.
One of them complained of posterior neck pain radiating to bilateral upper extremities. In X-ray and MRI studies, they show early degenerative changes of cervical spines and herniated cervical discs with compressing the spinal cords.
They were managed conservatively for several weeks by neck immobilization, absolute bed rest and continuous cervical traction. This resulted in restored strength in their extremities.
So, as a conclusion, we recommend that cervical myelopathy be expected in the patients with cerebral palsy who complain of newly developed functional deterioration. And we suggest conservative management using our protocol as a primary rehabilitation measure.
