To honor National Cerebral Palsy Awareness Month, we thought it would be good to present a few interesting facts about Cerebral Palsy and what are some of the current treatments.
Cerebral Palsy is the leading cause of childhood disabilities. Currently it is estimated that 764,000 children and adults in the US have cerebral palsy. The occurrence is 1 to 2.3 cases per 1,000 births.
Cerebral Palsy can affect individuals in varying ways from very mild motor disorders to major cognitive defects and wheelchair dependency. Cerebral Palsy is defined as an abnormality of movement due to a non-progressive lesion of the brain, and the precise cause is still unknown.
This motor dysfunction can also be accompanied by epilepsy, sight, hearing, speech, and communication disturbances. Spasticity is the most common movement disorder of Cerebral Palsy affecting 75% of all patients. Poor endurance, weakness is also associated with spasticity, along with contractures, joint dislocation, pain, and decreased growth.
Medication often prescribed to treat spasticity include, baclofen, clonidine, diazepam, dantrolene and tizanidine.
Baclofen is considered the first line of treatment. It inhibits neurotransmitters in the central nervous system these neurotransmitters are what cause the spasticity. Oral baclofen is approved for adults and children, but can cause weakness, ataxia, and orthostatic hypertension.
There is also intrathecal baclofen which is a pump implanted under the skin
which delivers baclofen directly into the spinal cord. It is dosed in micrograms as opposed to oral dosing which is milligrams and is felt to be more effective with less side effects. An individual would have to be 15kg in weight or 4 years of age for implantation. Contradiction for implantation is an allergy to baclofen or if the individual has an infection.
Diazepam (Valium) is one of the oldest treatments for spasticity due to cerebral palsy, but can cause sedation, decreased attention, ataxia, constipation, and urinary retention. Recent studies have concluded both Baclofen and Diazepam were found equally effective.
Dantrolene prevents full muscle contractions and therefore spasticity, but can result in general muscle weakness.
Botulism Toxins are also being used based on units/kg of body weight and has mild side-effects. The patient may experience soreness at the injection site and some weakness due to changes in muscle stiffness.
In conclusion, spasticity is the most common movement disorder of Cerebral Palsy and it’s affects are debilitating. As mentioned above, pharmacological therapy for spasticity can include oral, intrathecal, and intramuscular therapies, and a treatment plan can also consist of physical therapy, orthopedic therapy, surgical therapy, and pharmacological therapy to help achieve the best outcome.
We hope this has provided you with valuable information into the disability and possible treatment options.
Post written by Jane Greenblatt, RN, President of Home, Hope and Healing