Cerebral Palsy: Medications

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Medications

Medicines can help control some of the symptoms of cerebral palsy (CP), prevent or minimize complications, and treat other medical conditions related to CP.

Medication Choices

Antispasmodics are the most common medicines used for people with CP. Antispasmodics can help relax tight muscles and reduce muscle spasms. Most antispasmodics are taken orally and include:

• Diazepam (such as Valium).
• Baclofen (Lioresal).
• Dantrolene sodium (Dantrium).

Although these medicines are given as a pill to swallow (oral medicine), baclofen can also be given using a method called intrathecal baclofen (ITB). For this, a small pump is placed under the skin of the abdomen. This pump releases baclofen into the fluid around the spinal cord. ITB may be more helpful than taking a pill at relieving severe spasms. But it is harder to do than pills and has some risks (such as infection where the pump is implanted).

Injectable antispasmodics, which are injected directly into stiff or spasmatic muscles, are sometimes used to help them relax. These medicines typically remain effective for about 3 to 8 months, depending on the type used. Injectable antispasmodics used for treating CP include:

• Phenol or alcohol "washes."
• Botulinum toxin (Botox).

Anticonvulsants are used as treatment for people with CP who have seizures. Most commonly used anticonvulsants include:

• Gabapentin (Neurontin).
• Lamotrigine (Lamictal).
• Oxcarbazepine (Trileptal).
• Topiramate (Topamax).
• Zonisamide (Zonegran).

Anticholinergics help a minority of people with CP who have uncontrollable body movements (dystonic cerebral palsy) or who drool frequently. These include:

• Benztropine mesylate (Cogentin).
• Carbidopa-levodopa (Sinemet).
• Glycopyrrolate (Robinul).
• Procyclidine hydrochloride (Kemadrin).
• Trihexyphenidyl hydrochloride.

Stool softeners and mild laxatives may help treat constipation, which is a common complaint of people with CP.

What To Think About

Medicine for cerebral palsy (CP) targets individual needs. Unfortunately, medicine has had limited success in treating CP, especially the types that involve involuntary movements (athetoid type of dyskinetic cerebral palsy).

Botulinum toxin may be more useful than antispasmodic pills for treating CP.

Some medicines used to treat CP have serious side effects. For example, dantrolene sodium (Dantrium) can cause liver damage, so frequent blood tests are needed while taking this medicine. And in rare cases, the use of botulinum toxin is related to severe side effects, such as trouble breathing or swallowing.

Some doctors believe that the most commonly used medicines to treat CP (diazepam [such as Valium], baclofen [Lioresal], and dantrolene [Dantrium]) should not be given to growing children. They are concerned that the side effects from these medicines can cause problems for children that are more severe than the tight muscles and muscle spasms related to CP. For example, one side effect of these medicines is drowsiness. Drowsiness may interfere with a child's ability to concentrate and learn in school. Other doctors believe that the benefits of these medicines outweigh the risk of side effects.

Ask your doctor the following questions about any medicine prescribed for your child:

• How successful is it in treating your child's problem?
• What are the short-term and long-term side effects?
• What are the chances that the medicine will stop working? Discuss what options are available if this happens.
• How might it affect your child's growth and development?

See the new medicine information form (What is a PDF document?) for more questions to ask.

Last updated:	October 14, 2008
Author:	Debby Golonka, MPH
Reviewed By:	Michael J. Sexton, MD - Pediatrics, Louis Pellegrino, MD - Developmental Pediatrics
Editors:	Susan Van Houten, RN, BSN, MBA, Pat Truman, MATC