Treatment of Cerebral Palsy: Pharmeceuticals
Cerebral Palsy
Cerebral Palsy
Cerebral Palsy
Cerebral Palsy
Cerebral Palsy
Cerebral Palsy
Cerebral Palsy
Cerebral Palsy
Cerebral Palsy
Cerebral Palsy
Cerebral Palsy
Cerebral Palsy

Pharmeceuticals

There are many circumstances in which administering drug therapy can be quite helpful in alleviating symptoms associated with Cerebral Palsy. “Most common are those offered to control convulsions and those for relief of tensions and muscle spasm.” (Stanton, p. 49) Drug therapy can also be effective in the treatment of pain after operations, to aid with sleeping, constipation and reducing hyperactivity or anxiety. The decision to offer drug therapy must be made with the utmost attention and are, however, as it is absolutely necessary to monitor the effects of a certain drug on the patient, make sure the dosage is correct and will not lead to complications and can “be maintained within safe limits”.

Cerebral Palsy

Cerebral Palsy

Physicians usually prescribe drugs for those who have seizures associated with cerebral palsy, and these medications are very effective in preventing seizures in many patients. In general, the drugs given to individual patients are chosen based on the type of seizures, since no one drug controls all types. However, different people with the same type of seizure may do better on different drugs, and some individuals may need a combination of two or more drugs to achieve good seizure control.

Drugs to control seizures, also known as anticonvulsants, are general depressants chosen for the treatment of seizures “because they reduce excessive stimulation in the brain without depressing vital centers (such as the respiratory center) and without sending the patient to sleep. The cause and type of epilepsy must be established before treatment is offered.” Selecting the most suitable drug and dosage for a patient’s individual needs is important and may take several months to find one that is capable of controlling all the patient’s symptoms. It is crucial that patients follow the instructions for taking their prescriptions exactly and any adverse reactions should be noted and reported to the prescribing physician.

As with many prescription drugs, the dosage for the anticonvulsant described may need to be slowly increased over time, as the body will develop a tolerance to it. Unfortunately, however, the toxicity of a drug does not change, and the same amount will harm the system, whether or not the body has built up its tolerance. When the body’s tolerance to the anticonvulsant has reached a level in which prescribing a higher level would have the potential of harming the patient, another drug may be prescribed. The changeover must occur slowly, so as withdrawal symptoms from the anticonvulsant can me minimized, if not avoided completely. These symptoms cannot only be hugely uncomfortable, but also quite dangerous and sometimes deadly. The symptoms include: anxiety, restlessness, trembling, weakness, abdominal cramps, vomiting, hallucinations, delirium, fits and even death. As with any drug that can affect one’s cognitive ability, driving and operating machinery must be avoided if the patient develops drowsiness or other impairing side effects.

“Children require more regular and higher dosing than adults as they break down the drugs more quickly. Multiple drug therapy (combining more than one anticonvulsant) should be considered very carefully as this further complicates monitoring and increases the risk of adverse side-effects from the interaction of drugs.”

Drugs are also sometimes used to control spasticity, particularly following surgery. The three medications that are used most often are diazepam, which acts as a general relaxant of the brain and body; baclofen, which blocks signals sent from the spinal cord to contract the muscles; and dantrolene, which interferes with the process of muscle contraction. Given by mouth, these drugs can reduce spasticity for short periods, but their value for long-term control of spasticity has not been clearly demonstrated. They may also trigger significant side effects, such as drowsiness, and their long-term effects on the developing nervous system are largely unknown. One possible solution to avoid such side effects may lie in current research to explore new routes for delivering these drugs. In one such treatment, during a surgical procedure, a pump is implanted under the skin that continuously delivers the anti-spasmodic drug baclofen. This drug treatment is showing promise in children with moderate to severe spasticity.

 Unfortunately, oral drug treatment is often not very helpful as hoped. Another type of treatment that is Sometimes helpful is an injection of drugs such as Botox (botulinum toxin) directly into spastic muscles. The effects may last several months (allowing for more effective physical therapy during that time).

 Occasionally, doctors may use alcohol "washes" -- or injections of alcohol into a muscle -- to reduce spasticity for a short period. This technique is most often used when doctors want to correct a developing contracture. Injecting alcohol into a muscle that is too short weakens the muscle for several weeks and gives doctors time to work on lengthening the muscle through bracing, therapy, or casts. In some cases, if the contracture is detected early enough, this technique may avert the need for surgery.

 Patients with athetoid cerebral palsy may sometimes be given drugs that help reduce abnormal movements. Most often, the prescribed drug belongs to a group of chemicals called anticholinergics that work by reducing the activity of acetylcholine. Acetylcholine is a chemical messenger that helps some brain cells communicate and that triggers muscle contraction. Anticholinergic drugs include trihexyphenidyl, benztropine, and procyclidine hydrochloride.

Click here for a more complete chart of drugs commonly used in the treatment of Cerebral Palsy. (Stanton, Marion, The Cerebral Palsy Handbook, p 51 - 53)

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Treatment of Cerebral Palsy: Counseling, Music Therapy, Occupational Therapy,
Physical Therapy, Pharmeceuticals, Play Therapy, Speech Therapy and Surgery.