Dystonia in cerebral palsy patients: neuroanatomical and neurophysiological mechanisms of development and evolution

Cerebral palsy (CP) is the most common disease resulting in disability in childhood and adulthood. CP-related dystonia is the second most common syndrome and a major contributor to patient disability. Symptomatic treatment of CP-related dystonia is less effective than primary muscle dystonia. Recent research has improved our understanding of the neuronal and neurophysiological development mechanisms of dystonic phenomena and their specific aspects in CP patients. The review presents current information on motor system development mechanisms in the pre- and postnatal periods, describes strategically important structures involved in the development of motor circuits, and new connections of such structures. It discusses neuroplasticity mechanisms and their role in the development of dystonia. Pathogenetic features of dystonia in cerebral palsy patients are identified based on such data.