How medications help
Cerebral palsy (CP) affects people differently and has varying levels of severity. Some children have little to no symptoms while others have significant developmental delays, change in muscle tone, and/or motor, speech, and cognitive issues. There are medications that can help those with CP control their symptoms and secondary medical issues, leading to a more manageable life.
There are medications to treat both primary and secondary issues stemming from cerebral palsy. For instance, medications are prescribed for children with incontinence caused by an inability to control the muscles used for urination.
Common medications used to treat cerebral palsy
Each child with cerebral palsy is likely to have a unique combination of medications to treat their specific condition. Some medications are short-term, while others are long-term. Medications and dosages are often used in combination and will likely be adjusted over time.
Common classes of medications for children with cerebral palsy include:
- Muscle relaxants
- Nerve blocks
- Stool Softeners
Medications for spasticity
Spasticity is a condition where certain muscles contract continuously and involuntarily. This is the most common movement problem in children with cerebral palsy.
Spastic cerebral palsy causes spasms and stiff muscles. causes spasms and stiff muscles. This can be painful. Medications to control these symptoms may be given orally or through an injection. Some can be continuously infused through a small pump similarly to how Insulin can be given for diabetics.
Generalized spasticity is typically treated with muscle relaxants such as Baclofen or Botox and benzodiazepines such as Valium. Other medications can also be effective, and the health care team can help weigh the risks with the benefits
If spasticity is localized in a specific area, medication may be injected into those muscles. Botox is often used to reduce localized spasticity.
Common side effects from medications that reduce spasticity include:
- Loss of coordination
- Blurred vision
There are also more serious short and long-term side effects and some medications are not recommended for children.
Medications for involuntary movement
Athetoid cerebral palsy (also known as dyskinetic cerebral palsy) is characterized by low muscle tone and involuntary movements. abnormal muscle tone and involuntary movements. Children with dyskinetic CP may be prescribed medications to keep uncontrollable movements to a minimum.
Anticholinergic drugs ease symptoms by blocking nerve impulses that cause uncontrollable movements. They may also help control drooling, a common symptom of dyskinetic cerebral palsy.
Common side effects include:
- Dry mouth
Medications for seizures
Injuries to the brain increase the likelihood of developing seizures. Therefore, it isn’t surprising that many children with cerebral palsy develop some form of epilepsy. A report by the Centers for Disease Control in 2008 found that 41 percent of children with CP across multiple states had co-occurring epilepsy. There are several medications that reduce the frequency of seizures.
Two common types of medications used to treat seizures are barbiturates and benzodiazepines. Both slow the activity of the brain and nervous system which helps prevent seizures. Phenobarbital is a common barbiturate medication given to newborns with seizure activity. Benzodiazepines that are often prescribed include Valium, Ativan, Dilantin, and Versed. These drugs are useful anticonvulsants, muscle relaxants, and anti-anxiety drugs.
Anticonvulstant medications, such as Keppra, are commonly used in children with CP to prevent seizure activity.
Some of the common side effects of these drugs include:
Secondary conditions treated with medications
Secondary conditions are common in children with cerebral palsy and other birth injuries because of abnormal muscle movement and brain activity. Some examples of co-occurring conditions are acid reflux, constipation or incontinence, respiratory issues, and difficulty with feeds. Additionally, the brain damage that causes CP may also cause separate issues, such as intellectual disorders that require medication.
The inability to control urinary muscles often leads to incontinence. Tofranil is an antidepressant that can also be used to contract the bladder neck muscles and control incontinence. DDAVP (desmopressin acetate) mimics natural hormones to decrease urine production and can be used as a nasal spray.
A secondary issue caused by a lack of muscle control is gastroesophageal reflux. In children with CP, the muscle that prevents stomach acid from traveling up the esophagus may not be strong enough to prevent acid reflux. Over-the-counter medications that decrease acid production in the stomach, such as Zantac, are often beneficial.
Some children with cerebral palsy develop behavioral or intellectual disorders. Attention deficit hyperactivity disorder (ADHD) and autism are common in children with CP. Adderall and Ritalin are some of the most common medications used to treat ADHD. Antipsychotic medications, such as Risperidone, are used to help with Autism symptoms.
Lactulose is a synthetic sugar used to treat constipation. MiraLax is often used to treat children with constipation. It works by drawing water into the bowels to help soften stool and move it through the GI tract. This is considered to have low side effects.
Increased oral secretions
Children with CP often have limited or no motor control leading to excessive drooling. Anticholinergic medications, such as Rubinol, are effective in controlling the increased oral secretions.
Is medication necessary?
Many parents are understandably concerned about placing their children on medications. Fear of side effects and dependence on these medications often lead parents to explore alternatives.
Activities such as yoga, chiropractic care, music, aquatic therapy, acupuncture, occupational, and physical therapy can be effective in treating the symptoms related to CP and are often used in conjunction with medications.
Doctors and members of the care team can help decide what is best for your loved one. Please consult your child’s doctor before changing or discontinuing any medications. Doctors strive to tailor medications to each child’s specific needs. Discussing your goals and quality of life expectations with your child’s care providers can help your family find the best strategies to balance CP and its challenges.
To learn more about the various medications used to treat cerebral palsy, try downloading our free Cerebral Palsy Guide. This guide includes over 12 pages of in-depth information for children and parents of a child with CP.