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Familal Spastic Paraparesis (FSP), synonymous with Hereditary Spastic Paraplegia (HSP), are a group of genetic disorders that resemble Cerebral Palsy in the involvement of the lower extremeities.

My Approach:

FSP is variable in its presentation of age from childhood to adulthood, and its severity from mild to quite severe. For this reason, making the diagnosis is important and creating symmetry is essential. Balancing the muscles and utilizing all modalities carefully is often effective in maintaining ambulation in this patient population.

More Information:

May present from childhood to adulthood as a gait disturbance and spasticity.


Varied genetic mutation in SPG3A, SPG4A and SPG31 as well as others.

Diagnosis Methods:

FSP is diagnosed through genetic testing.


The most important factor distinguishing FSP from standard CP is that is often progressive and because all the muscles of the extremity may be involved, doing simple lengthening of the muscles may be quite detrimental and lead to imbalance. Symmetry is key. Utilizing a Baclofen pump and perhaps Rhizotomy may be effective.

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