What Type of Drug Treatments are Available to Treat a Person With Cerebral Palsy?
People with cerebral palsy experience a range of symptoms such as muscle shortening and spasticity, chronic pain, and lack of ability to ambulate. Other comorbid conditions can cause seizures, cognitive deficits, and behavioral issues. As a result, many types of drug treatments exist to address the symptoms of cerebral palsy. The purpose of medication is to effectively manage symptoms, alleviate pain, prevent neurological damage, and improve quality of life.Oral Medications for Cerebral Palsy
Doctors often turn to oral medications as a first line treatment for cerebral palsy. The purpose of these medications is to relax stiff or contracted muscles (hypertonia) and to prevent spastic activity that can lead to pain. The most common oral medications for cerebral palsy include:
- Dantrolene sodium
Like any other treatment, oral medication has both benefits and risks. Possible side effects of these medications may include upset stomach, drowsiness, high blood pressure, and liver damage. If a doctor prescribes an oral medication for cerebral palsy, it is because he or she feels the benefits outweigh the potential risks of taking it. Oral medications are most appropriate for children with mild cases of cerebral palsy who only need minimal reductions in muscle tone. They may be appropriate for people who experience widespread spasticity of muscles.
Doctors will also use alcohol washes, or injections, in an attempt to control muscle spasticity. Correct injection of the alcohol wash can effectively curb symptoms for a few months to a couple of years. On the other hand, potential risks include neuropathy and pain, and the procedure requires a high degree of skill.Treatment With Botulinum Toxin
Botulinum toxin has long served medical purposes, one of which is to treat spasmodic activity of the muscles in children affected by cerebral palsy. Botulinum toxin, or BT-A, works to relax contracted muscles by keeping the nerves from overstimulating it. BT-A treatment is not officially recognized by the Food and Drug Administration (FDA) as a treatment for cerebral palsy, but doctors have been using it off-label since the 1990s for this purpose because it promotes a better quality of life with minimal side effects.
A BT-A injection will last approximately three months. It does have potential side effects, which can range from flu-like symptoms for a few days to pain at the injection site. It works best when used in conjunction with physical therapy techniques like stretching programs.Treatment With Implantation
Recently, doctors have taken to using an implantable pump to deliver the popular muscle relaxant baclofen into a patient's system. The medication works by decreasing stimulation of the nerve cells in the spinal cord, which in turn reduce spastic muscle activity throughout the body. Direct infusion into the nervous system means that people can take much lower doses of the medication, mitigating its side effects.
Implantation of the pump requires surgery. A surgeon places it into the abdomen and it contains a reservoir that's connected to an alarm, which will sound when the baclofen supply is low. The dose can also be adjusted externally to reflect the natural patterns of spasticity - for example, if a child is more spastic at night, the dose may adjust automatically to reflect this activity.
Since pump insertion requires surgery, this route has serious risks. Parents should discuss the risks and benefits with their providers before making any decisions. Potential side effects upon insertion include problems with the catheter and infection at the surgery site.
Several potential medical treatments for cerebral palsy exist, and each has their risks and benefits. The best method of treatment will depend on a child's needs and parental preference.