Cerebral Palsy

Treatment Options

Presently, there is no cure for cerebral palsy and current treatment options can only reduce the disabilities associated with cerebral palsy. The therapy regimen is tailored to meet the specific needs of an individual and it differs from one individual to other (6).

A multidisciplinary team of health care professionals develops a treatment plan in close coordination with patients, families, teachers and caregivers. A pediatrician, pediatric neurologist, or pediatric physical therapist provides primary care to children suffering from cerebral palsy whereas a family doctor, neurologist or physiatrist provides primary care to adults suffering from cerebral palsy.

Physical Therapy:

In this therapy, tailor made exercises and activities are planned to work towards two important goals - preventing weakening or deterioration of the muscles (disuse atrophy) and maintaining flexibility of muscles (contracture).

Children and adolescents suffering from mild cerebral palsy undergo resistive exercise programs (strength training) to optimize muscle performance. Physical therapy with special braces (orthotic devices) helps prevent contracture by stretching spastic muscles (1).

Occupational Therapy:
This therapy optimizes upper body function, improves posture and makes the most of a child’s mobility. “An occupational therapist helps a child master the basic activities of daily living, such as eating, dressing, and using the bathroom alone” (1).

Recreational Therapy:
Gross motor skills, speech and self-esteem improve in children undergoing this type of therapy (1).

Speech and Language Therapy:
Children suffering from athetoid cerebral palsy have trouble in word pronunciation (dysarthria) and swallowing (dysphagia). Speech therapy helps improve communication and swallowing (7).

Speech and language therapists diagnose and treat communication disorders related to cerebral palsy with the help of a program of exercises to overcome specific communication problems.

The therapist can help children master social skills involved in communicating such as keeping their head up, maintaining eye contact and repeating themselves when the other person is unable to understand (1).

Drug Treatments:
Initially, oral medications such as diazepam, baclofen, dantrolene sodium, and tizanidine are used to relax stiff, contracted or overactive muscles. Long-term usage has certain side effects such as drowsiness, upset stomach, hypertension, and liver damage.

Alcohol “washes” or alcohol injections into muscles are used to reduce spasticity but with certain adverse effects such as significant risk of pain or numbness.

Overactive muscles in children suffering from spastic movement disorders due cerebral palsy are treated by injecting locally Botulinum toxin (BT-A) leading to relaxation of contracted muscles.

In Intrathecal baclofen therapy, an implantable pump is used to deliver baclofen, a muscle relaxant into the fluid surrounding spinal cord. Baclofen reduces the excitability of nerve cells in the spinal cord, which in turn reduces the muscle spasticity throughout the body. This therapy is recommended for individuals suffering from chronic, severe stiffness or uncontrolled muscle movement throughout the body (1).

Dopaminergic drugs are widely used to increase the dopamine level in the brain leading to a reduction in rigidity and abnormal movements of muscles. Levodopa/Carbidopa (Sinemet) and Trihexyphenidyl (Artane) are some of the examples of dopaminergic drugs (6).

Prevention Methods

The exact causes of cerebral palsy are not known and it cannot be prevented. However, some of the important causes such as premature birth, low birth weight, infections and head injuries can be prevented in many cases.

• Appropriate pre-pregnancy scheduled visits must be maintained for a healthy pregnancy and prenatal care must be provided to pregnant women.

• Pregnant women must avoid smoking, alcohol and drugs during pregnancy to avoid premature delivery.

• To avoid rubella (measles) during pregnancy, the mother must get immunized before becoming pregnant.

• The Rh factor of pregnant women must be tested and Rh incompatibility appropriately treated to avoid brain damage.

• Babies must be vaccinated to prevent serious infections.

• The child must be instructed and encouraged to wear a helmet when riding a bicycle (6).

Article by Kona Vishnu, MS
Medical Writer,
OmniMedicalSearch.com

Sources:

1. Cerebral Palsy: Hope Through Research (2007). National Institute of Neurological Disorders and Stroke.
2. Nan Colledge. A Guide to Cerebral Palsy. Ontario Federation for Cerebral Palsy (OFCP)..
3. What Is Cerebral Palsy? Ontario Federation for Cerebral Palsy (OFCP)..
4. Cerebral Palsy – risk factors (2007). Neurology channel.
5. Cerebral Palsy – Signs and Symptoms (2006). Mayoclinic.com.
6. Cerebral Palsy (2007). eMedicineHealth.com
7. Cerebral Palsy – Treatment (2007). Neurology channel.

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