1995 年 7 巻 3 号 p. 113-118
In patients with cerebral palsy of the tension athetosis type, a number of symptoms may be observed, including not only the fairly constant involuntary athetotic movements but also myotonic disorders of the motor function of all four limbs and trunk, vocalization and motions associated with eating such as mastication and swallowing. Aggravation of involuntary movements and pain in the neck and back are also seen in many cases. Existing conservative treatment methodologies have proved to be more or less ineffective, and limitations in functional training in adults have made treatment extremely difficult. We first employed low reactive-level laser therapy (LLLT) in a case of spastic cerebral palsy in 1994 with good results. In the present study, we applied laser irradiation (830 nm. 60 mW continuous wave) to all myotonic sites around the face and neck region where myotonia was severe in 20 patients with cerebral palsy of the adult tension athetosis type for which there was no effective treatment for their neck and back pain. Improvement of myotonia was seen in 19 patients while improvement of pain in the neck and back was seen in all the 16 patients who had pain in these regions. Suppression of myotonia reduced tonic vocalization making words easily heard; moreover, suppression of myotonia and involuntary movements improved working efficiency enabling the patient to perform fairly complex tasks such as word processing. Insomnia and dysuria also improved. Even in the most severe cases, assisting the patient became easier and breathing improved. LLLT with the 830 nm diode laser provides a new and effective treatment modality in this extremely problematic condition, has no serious side effects, and has the potential to improve these patients’ quality of life.
