Cerebral Palsy

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Questions to Ask Your Doctor about Cerebral Palsy
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Medications

Medications may be used to treat symptoms of cerebral palsy (CP). As with many forms of drug therapy, a certain amount of experimentation may be required before optimum results are achieved.

Seizures—No single drug controls all types of seizures, and no two patients respond identically to any given drug. Medications are divided into first-generation anticonvulsants (older medications) and second-generation anticonvulsants (more recently developed).

Spasticity—The muscle relaxants diazepam (Valium®) and dantrolene (Dantrium®) may be prescribed to control muscle contraction (myoclonus). These drugs reduce spasticity for short periods, and their long-term value is uncertain. The long-term effect of these drugs on a child's developing nervous system is unknown.

Side effects of diazepam include drowsiness, slurred speech, constipation, nausea, and incontinence. Common side effects of dantrolene include drowsiness, dizziness, general weakness, and diarrhea.

The most common side effect of phenobarbitol is drowsiness. Other effects include dizziness, slowed heart rate, confusion, constipation, and nausea. Phenobarbitol and the other barbiturates can become habit forming.

Baclofen is a muscle relaxant and antispastic medication that is available in tablet and injectable forms. Intrathecal baclofen uses a very small implanted pump to deliver a steady supply of medication into the fluid around the spinal cord. Strict compliance with the refill schedule is imperative to avoid abrupt withdrawal and resulting severe complications, including death.

Side effects associated with baclofen include confusion, dizziness, drowsiness, headache, insomnia, nausea, hypotension, and urinary frequency.

Anticholinergics may be prescribed to control the abnormal movements associated with athetoid cerebral palsy. These drugs inhibit the effects of acetylcholine, a chemical in brain cells that triggers muscle contraction. The most commonly prescribed anticholinergic drugs are trihexyphenidyl (Artane®), benztropine (Cogentin®), and procyclidine hydrochloride (Kemadrin®).

Side effects associated with anticholinergic drugs include dry mouth, constipation, agitation, and painful urination (dysuria).

Botulinum toxin, or BOTOX® Cosmetic, is injected directly into muscle. BOTOX® Cosmetic blocks acetylcholine and alleviates muscle spasm for 3-6 months. Botulinum toxin may produce muscle weakness.

In some cases physicians may try to reduce spasticity or correct a developing contracture by injecting phenol into a muscle. This weakens the muscle and gives physicians and therapists a chance to stretch and lengthen the muscle with therapy, bracing, or casts. If the contracture is treated early enough, the need for surgery may be avoided.

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