Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Operations used in the treatment of cerebral palsy include the following.
Dorsal rhizotomy: In this procedure, a few specific nerves are cut at their roots where they branch off the spinal cord. In certain individuals with cerebral palsy, this works very well to reduce spasticity and improve the ability to sit, stand, and walk.
Implantation of a baclofen pump: The muscle relaxant drug baclofen can be very helpful in reducing spasticity in some people with cerebral palsy, but it works best when it is given continuously. A tiny pump can be placed in the abdominal wall to deliver a continuous dose to the spastic muscles of the limbs.
Reconstructive surgery to an arm can restore muscle balance, release contractures, and stabilize joints. This can improve placement of the hand in space and the important ability to grasp, release, and pinch.
Skeletal problems such as hip dislocation and scoliosis can be corrected with surgery.
Severe spasticity can be corrected with a number of surgical procedures, including tenotomy, a tendon-lengthening procedure.
Surgical operations for intractable epileptic seizures: These procedures are now well-accepted. There is enough experience in the Epilepsy Centers that surgery, in selected cases, may be an excellent option.
Vagal nerve stimulation (VNS) incorporates an implantable device that stimulates the vagal nerve in the neck. This method has been used with some success in epileptic disorders that are refractory to antiepileptic medications.