Letters NICE on spasticity

Authors’ reply to Crilly, and Willoughby and Graham

BMJ 2012; 345 doi: https://doi.org/10.1136/bmj.e6679 (Published 09 October 2012) Cite this as: BMJ 2012;345:e6679
  1. Moira A Mugglestone, director of guideline development1,
  2. Paul Eunson, consultant paediatric neurologist2,
  3. M Stephen Murphy, clinical co-director (children’s health)1
  4. On behalf of the Guideline Development Group
  1. 1National Collaborating Centre for Women’s and Children’s Health, London W1T 2QA, UK
  2. 2Royal Hospital for Sick Children, Edinburgh EH9 1LF, UK
  1. mmugglestone{at}ncc-wch.org.uk

Opinions differ on the place of selective dorsal rhizotomy in managing spasticity in children. In a recent debate in the House of Commons it was strongly advocated, as being “more robust than any other treatment for cerebral palsy.”1

We as guideline developers knew about the lack of high quality clinical evidence for the procedure, particularly in relation to important functional benefits and long term outcomes. We considered the three randomised controlled trials in the meta-analysis cited by Crilly. …

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