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Treatments and drugs
By Mayo Clinic staffThe brain abnormality or damage that underlies cerebral palsy doesn't worsen with time, but children with cerebral palsy often require long term care. The type and amount of treatment depend on how many problems your child has and how severe they are.
Medications
- Muscle relaxants. Oral medications — such as diazepam, baclofen, dantrolene and tizanidine — are usually the first option to relax stiff, contracted muscles. Side effects may include drowsiness and upset stomach. Baclofen can also be delivered directly to the fluid surrounding the spinal cord via a pump surgically implanted into the abdomen.
- Botulinum toxin type A (Botox). Injections of botulinum toxin directly into spastic muscles also can help relieve the muscle spasms and contractures common to cerebral palsy. However, these injections have, in rare instances, caused serious problems with swallowing and breathing, particularly in children with cerebral palsy.
Therapies
- Physical therapy. Muscle training and exercises may help your child's strength, flexibility, balance, motor development and mobility. Braces or splints may be recommended for your child. Some of these supports are used to help with function, such as improved walking. Others may stretch stiff muscles to help prevent contractures.
- Occupational therapy. Using alternative strategies and adaptive equipment, occupational therapists work to promote your child's independent participation in daily activities and routines in the home, school and community. They may also address difficulties with feeding and swallowing.
- Speech therapy. Speech therapists help improve your child's ability to speak clearly or to communicate using sign language. They can also teach your child to use special communication devices — such as a board covered with pictures of everyday items and activities. Sentences can be constructed by pointing to the pictures.
Surgical or other procedures
- Orthopedic. Children with severe contractures or deformities may need surgery on tendons, bones or joints to place their arms and legs in their correct positions. This can make it easier to use a walker, braces or crutches.
- Severing nerves. In some severe cases, when other treatments haven't helped, surgeons may cut the nerves serving the spastic muscles. This relaxes the muscle and reduces pain, but can also cause numbness.
References
- Cerebral palsy: Hope through research. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/cerebral_palsy/detail_cerebral_palsy.htm. Accessed Sept. 2, 2008.
- Miller G. Epidemiology and etiology of cerebral palsy. http://www.uptodate.com/home/index.html. Accessed Sept. 2, 2008.
- Miller G. Clinical features and diagnosis of cerebral palsy. http://www.uptodate.com/home/index.html. Accessed Sept. 3, 2008.
- Parmet S, et al. JAMA patient page: Chickenpox. Journal of the American Medical Association. Accessed Sept. 4, 2008.
- Neurological consequences of cytomegalovirus infection information page. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/cytomegalic/cytomegalic.htm. Accessed Sept. 4, 2008.
- Toxoplasmosis: Pregnant women. Centers for Disease Control and Prevention. http://www.cdc.gov/toxoplasmosis/pregnant.html. Accessed Sept. 4, 2008.
- CDC fact sheet: Syphilis. Centers for Disease Control and Prevention. http://www.cdc.gov/std/Syphilis/syphilis-fact-sheet.pdf. Accessed Sept. 4, 2008.
- Meningitis and encephalitis fact sheet. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/encephalitis_meningitis/detail_encephalitis_meningitis.htm. Accessed Sept. 4, 2008.
- Neurological diagnostic tests and procedures. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/misc/diagnostic_tests.htm. Accessed Sept. 4, 2008.
- Miller G. Management and prognosis of cerebral palsy. http://www.uptodate.com/home/index.html. Accessed Sept. 5, 2008.
