Peripheral sensory neuropathy observed in children with cerebral palsy: is chronic afferent excitation from muscle spindles a possible cause?

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Childs Nerv Syst. 2010 Jun;26(6):751-4.

Peripheral sensory neuropathy observed in children with cerebral palsy: is

chronic afferent excitation from muscle spindles a possible cause?

Fukuhara T, Namba Y, Yamadori I.

Department of Neurological Surgery, National Hospital Organization Okayama

Medical Center, 1711-1 Tamasu, Kita-ku, Okayama, 701-1192, Japan.

Abstract

INTRODUCTION: Peripheral sensory neuropathy is known to be associated with

several medical conditions; however, it has not been reported in patients with

cerebral palsy. Authors have observed pathological changes in the sensory nerve

rootlets taken during selective dorsal rhizotomy. This paper reports a possible

novel cause of peripheral sensory neuropathy: the chronic afferent excitations

from muscle spindles.

CASE REPORT: Sensory nerve rootlets on L5 were taken for histological evaluation

from two children with cerebral palsy during selective dorsal rhizotomy,

performed for their leg spasticities. Rootlets with clonus reaction against

intraoperative electrical stimulation show dysmyelination, and in one child,

axonal degeneration can also be observed. Rootlets with normal reaction have

only minimum changes on their myelin sheath.

CONCLUSION: As cerebral palsy is a typical upper motor neuron disorder,

peripheral sensory neuropathy is unexplained. Since observed neuropathy is

mainly on the myelin sheath, the etiology is considered to be the chronic

overload of afferent impulses from muscle spindles in the spastic muscle.

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