Which of the following is a non-surgical management option for CP?

• A. Oral baclofen
• B. Selective dorsal rhizotomy
• C. Hemi-epiphysiodesis
• D. Distal femoral extension osteotomy

Answer: (A)

Non-surgical management of spasticity in cerebral palsy often starts with medications that dampen nerve activity. Oral baclofen works by activating GABA-B receptors in the spinal cord, which reduces the excitability of motor neurons and lowers muscle tone. This can help improve range of motion, ease care tasks, and support participation in therapy, with dosing tailored to balance benefit and side effects like drowsiness, dizziness, fatigue, or hypotonia. It’s a systemic approach, not a procedure.

The other options involve surgery. Selective dorsal rhizotomy removes specific sensory nerve roots to lessen spastic input, which is a neurosurgical intervention. Hemi-epiphysiodesis and distal femoral extension osteotomy are growth- or bone-altering procedures to address angular deformities and gait, requiring operative intervention rather than a non-surgical management strategy.