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Are there treatments for conditions associated with cerebral palsy?

Since there is no cure for cerebral palsy itself, the general consensus is that the best practice is to treat the underlying medical conditions.  Below are complications frequently associated with people whom have been diagnosed with cerebral palsy as well as the treatment options frequently suggested by the medical community.

Epilepsy

Twenty to 40 percent of children with mental retardation and cerebral palsy also have epilepsy. Doctors usually prescribe medications to control seizures. The classic medications for this purpose are phenobarbital, phenytoin, carbamazepine, and valproate. Although these drugs generally are effective in controlling seizures, their use is hampered by harmful or unpleasant side effects.

Treatment for epilepsy has advanced significantly with the development of new medications that have fewer side effects. These drugs include felbamate, gabapentin, lamotrigine, levetiracetam, oxcarbazepine, tiagabine, topiramate, vigabatrin, and zonisamide.

In general, drugs are prescribed based on the type of seizures an individual experiences, since no one drug controls all types. Some individuals may need a combination of two or more drugs to achieve good seizure control.

Incontinence

Medical treatments for incontinence include special exercises, biofeedback, prescription drugs, surgery, or surgically implanted devices to replace or aid muscles. Specially designed absorbent undergarments can also be used to protect against accidental leaks.

Osteopenia

Children with cerebral palsy who aren’t able to walk risk developing poor bone density (osteopenia), which makes them more likely to break bones. In a study of older Americans funded by the National Institutes of Health (NIH), a family of drugs called bisphosphonates, which was recently approved by the FDA to treat mineral loss in elderly patients, also appeared to increase bone mineral density. Doctors may choose to selectively prescribe the drug off-label to children to prevent osteopenia.

Pain

Pain can be a problem for people with cerebral palsy due to spastic muscles and the stress and strain on parts of the body that are compensating for muscle abnormalities. Some individuals may also have frequent and irregular muscle spasms that can’t be predicted or medicated in advance.

Doctors often prescribe diazepam to reduce the pain associated with muscle spasms, but it’s not known exactly how the drug works to interfere with pain signals. The drug gabapentin has been used successfully to decrease the severity and frequency of painful spasms. BT-A injections have also been shown to decrease spasticity and pain, and are commonly given under anesthesia to avoid the pain associated with the injections. Intrathecal baclofen has shown good results in reducing pain, but its delivery is invasive, time intensive, and expensive.

Some children and adults have been able to decrease pain by using noninvasive and drug-free interventions such as distraction, relaxation training, biofeedback, and therapeutic massage.

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