Effective cerebral palsy treatment uses every available measure to create positive outcomes for patients challenged by the disorder. Medication is used alongside various forms of therapy, assistive technology, and rehabilitation, to enhance patients’ abilities, manage symptoms and increase comfort.
Antispasmodic drugs, for example, relieve muscle spasms commonly seen with cerebral palsy. Other medications can help control pain and co-occurring conditions.
Medication for Cerebral Palsy
Severity of symptoms, the areas of the body involved, and availability of other forms of effective treatment are key considerations when prescribing medication for cerebral palsy. Like other forms of therapy, medication is administered according to the particular needs of each patient.
When isolated spasticity is present, for example, localized injections may help reduce stiffness in affected areas. Relieving generalized spasticity, on the other hand, may call for oral muscle relaxants.
What Types of Drug are Used to Treat Cerebral Palsy?
Medication is used to alleviate cerebral palsy symptoms and prevent complications. Several classes of drugs provide relief for cerebral palsy patients, including these medications:
- Dopaminergic drugs – This medication, commonly used to treat Parkinson’s disease, raises the body’s dopamine level, leading to less rigidity and better muscle control.
- Muscle relaxants – Stiff, spastic musculature plagues cerebral palsy patients, so medications are used to relax muscle groups. Drugs like baclofen can be taken orally or administered by an automatic, metered pump.
- Benzodiazepines – Relaxants, such as Valium, work on brain chemistry to ease certain CP conditions.
- Glycopyrrolates – Helps to releive stomach and abdominal pain. Belongs to a class of drugs known as “Anticholinergics”.
Spasticity and Drug Therapy Medications for Cerebral Palsy
The most widely diagnosed form of cerebral palsy, spastic cerebral palsy is characterized by tight, stiff muscles in the arms and legs. Patients can be impacted on one or both sides, with more pronounced symptoms in the lower extremities.
When muscles remain tight over time, contracture can occur, bending joints into rigid, fixed positions. The condition interferes with mobility, causing pain and complications in many cases. Treating spasticity is a fundamental concern for specialists working with cerebral palsy patients. Principal medications for treating spasticity include:
- Baclofen – This muscle relaxant is often prescribed to treat spasticity resulting from cerebral palsy. The drug can be taken orally, and since 1996, is also available in a pump delivery system, which administers the medication directly to the spinal cord. Individual doses may cause sleepiness, nausea, headache, and lightheadedness, which can often be remedied by adjusting dosing. Baclofen helps to provide long-term reductions in muscle spasticity. Baclofen also is there to help improve speech, movement, swallowing, and alertness.
- Dantrium/Dantrolene – Severe spasms are treated with this muscle relaxant, which relieves pain and can help CP patients achieve greater range of movement. The drug can make users feel dizzy, drowsy, fatigued or weak, and serious liver damage may occur with long-term use. The drug has not been approved for children under 5. Dantrolene is most frequently administered orally, but other options are available during surgery.
- Diazepam/Valium – Drugs like Valium serve as general relaxants, relieving widespread CP symptoms. In addition to easing muscle tension, diazepam may help with seizures. Side effects may include drowsiness, headache, depression and dizziness.
- Botox – Direct injections to affected muscles can ease spasticity, reducing muscle contractions from cerebral palsy. Headache and muscle ache are common side effects. Botox injections into the affected muscles usually last 12-16 weeks providing reduced muscle spasticity.
- Flexeril – A well knows muscle relaxant that works to block nerve impulses the body sends to the brain. This drug is commonly known for short term use when suffering from muscle injuries or spasms. Flexeril is less commonly used for cerebral palsy patients compared to other working drugs. Some side effects include dizzy spells, insomnia, and drowsiness.
Seizure Medication for Cerebral Palsy Patients
Estimates vary, but it is thought as many as 50% of those diagnosed with cerebral palsy experience seizures. A 2008 CDC study, for instance, returned data indicating 41% of cerebral palsy patients evaluated in four US states had co-occurring epilepsy. The condition occurs when excessive and irregular brain cell activity causes electrical impulses to misfire.
When seizures happen, patients are typically affected for a short time, succumbing to various symptoms, which can include loss of consciousness. There are often few signs present between episodes. Certain medications can help manage CP-related seizures:
- Depakene – Also known as “Valproate” or “Valreease”. This medication is not exactly known how it treats seizures, but has been used to treat both petit mal and grand mal seizures.
- Petit mal seizures – Also known as “Absence” seizures involve quick, sudden lapses of consciousness. Petit mal seizures are more commonly experienced with children. The most commonly known symptom may appear if the individual is staring into space for a select few moments. This form of seizure rarely leads to physical damage.
- Grand mal seizures – Also known as a “General Tonic-Clonic Seizure”. Grand mal seizures are known to produce heavy muscle contractions and frequent loss of consciousness. Caused by abmormal electrical activity in the brain, grand mal seizures usually only happen once to an individual. Anti seizure medications and therapy are able to control this type of event from producing itself again.
- Diazepam – Also known as “Valium” this drug is a sedative, anti-convulsant and muscle relaxant. Also used for anxiety and minor surgeries, Diazepam is most commonly known to relieve seizures, relieve muscle spasms and spasticity for cerebral palsy sufferers. Some side effects are drowsiness, depression, headaches, lethargy, confusion, and dizziness.
- Dilantin – Another medication used to prevent and control seizures. Dilantin can be given in multiple forms: by mouth, injection, liquid, or intravenously. This drug is best known for helping to reduce and control seizures more affectively than other medications on the market.
- Epival – Also known as “Divalproex”, another drug known to help control seizures for individuals with cerebral palsy. Epival is given orally only, and should not be given to children under the age of 2.
- Klonopin – Also called Rivotril, is a “anticonvulsant” drug used to treat both forms of seizures. One benefit to this medication is that you can combine with other seizure medications to improve overll effectiveness for individuals with cerebral palsy.
- Tegretol – Is known to treat all types of seizures along with pain caused by nerve damage or developmental disorders. Tegretol is available in both tablet and liquid form to help relieve pain caused by neurological disorders. Some side effects include swelling, increased blood pressure, and leg cramps.
- Zarontin – Also known as “Ethosuzimide” is primarily known to treat petit mal seizures only. Zarontin can be taken in both capsule and liquid form which can help control or eliminate petit mal seizures completely. Common side effects include lethargy, stomach aches, and confusion.
Other Options for Cerebral Palsy Patients
Effective cerebral palsy treatment uses medication in combination with therapy, surgery and other forms of intervention. Because cerebral palsy treatment begins at a very young age, some parents and doctors share concerns about the side effects of long-term prescription drug therapy. A healthy diet, physical therapy and other treatment options can reduce reliance on medication.
Maintaining a special diet, rich in certain fats, may have anti-seizure benefits for children with cerebral palsy. The ketogenic diet allows patients to consume few carbohydrates, so the body must use fat to generate energy. The process creates “ketones”, which protect the body from seizures. A high fiber diet, with adequate fluid intake, is another example of preventative nutrition, which can keep patients regular and in control.
Various forms of therapy help cerebral palsy patients – without the use of pharmacological agents. However, physical, occupational, and other therapies may be more effective when paired with medication.