Medical Management for Children with Cerebral Palsy

Cerebral palsy management is aimed at improving functional ability, independence, and management of secondary complications. 

The following are the main management strategies:

• Physical therapy
• Occupational therapies
• Mechanical aids
• Orthopedic surgery to address patients' motor problems
• Medical and surgical treatment of medical comorbidities (Novak, 2017)

Here are some major considerations in the management of CP:

• Major factors for improvement occur from addressing physical issues, cognition, communication, eating and drinking, vision, and sleep.
• Early intervention helps in early neuroplasticity of the brain – Two trials, GAME and REACH, are testing the results of early intervention (Tebani, 2021; Hutchon et al, 2019).
• Spasticity management – Spastic muscles, dystonia, difficulties in coordination, strength, selective motor control.

Using an extensive team approach that includes audiologists, medical social workers, nurses, pediatric gastroenterologists, pediatric neurologists, pediatric orthopedic surgeons, pediatric neurologists, pediatric pulmonologists, pediatricians, physiotherapists, psychologists, speech-language therapists, and special educators is recommended for the best results (Patel et al., 2020).

Here are some medical managements that are found to be effective:

• Multilevel surgery for epilepsy (Paul et al., 2022)
• Benzhexol hydrochloride for saliva control and laxatives for constipation (Padmakar et al., 2019) NSAIDs to reduce pain (Harvey et al., 2021)
• Gabapentin for treatment of dystonic CP (Harvey et al., 2021)
• Physical, occupational, speech, and behavioral therapies can improve support and communication with patients and caregivers (Padmakar et al., 2019).

For more information and details about the management of cerebral palsy, review this free-to-view reference: Paul, S., Nahar, A., Bhagawati, M. & Kunwar, A.J. (2022). A Review on Recent Advances of Cerebral Palsy. Oxid Med Cell Longev. 2022, 2622310. https://pubmed.ncbi.nlm.nih.gov/35941906/

References

Harvey, A., Waugh, M. C., Rice, J., et al. (2021). A pilot feasibility study of gabapentin for managing pain in children with dystonic cerebral palsy. BMC Pediatrics . 21(1), 368.

Hutchon, B., Gibbs, D., Harniess, P., et al. (2019). Early intervention programs for infants at high risk of atypical neurodevelopmental outcome. Developmental Medicine and Child Neurology .  61(12), 1362–1367.

Novak, I., Morgan, C., Fahey, M., et al. (2020). State of the evidence traffic lights 2019: systematic review of interventions for preventing and treating children with cerebral palsy. Current Neurology and Neuroscience Reports. 20(2), 3.

Padmakar, S., Kumar, K., Parveen, S. (2019). Management and treatment of cerebral palsy in children. Indian Journal Of Pharmacy Practice. 10:194–199.

Patel, D. R., Neelakantan, M., Pandher, K. & Merrick, J. (2020). Cerebral palsy in children: a clinical overview. Translational Pediatrics.  9(1), S125–S135.

Paul, S., Nahar, A., Bhagawati, M, & Kunwar, A.J. (2022). A Review on Recent Advances of Cerebral Palsy. Oxid Med Cell Longev. 2022, 2622310.

Tebani, A. & Marret, S. (2021). Early intervention in cerebral palsy and beyond. JAMA Pediatrics.  175(8),785–787.

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