The earlier a child is treated for cerebral palsy, the better chance the child has to improve mobility and cognitive development. Early intervention takes advantage of the body’s greater resiliency in youth.
But even after early treatments, cerebral palsy must be well managed over a person’s lifetime. As those with cerebral palsy grow into adolescence, adulthood, and older age, their needs may change and they may require different treatment approaches.
Cerebral palsy can involve a number of different disabilities and complications, so treatment is multidisciplinary. That means treatment involves visits to doctors and care providers from various specialties.
Depending on a person’s particular needs, any of the following types of healthcare professionals may participate in the treatment team:
- A developmental pediatrician diagnoses cerebral palsy and tracks a person’s overall physical, emotional, and cognitive development.
- A neurologist, possibly more than one if the person has a seizure disorder, may prescribe medications designed to address a person’s brain injuries.
- A physical therapist helps a person manage physical difficulties.
- An occupational therapist helps a person learn everyday living skills.
- A speech therapist helps with language development.
- An orthopedic surgeon recommends and performs surgeries.
- A respiratory therapist helps with breathing problems.
- A nutritionist or dietitian recommends a healthy diet.
- Psychologists assess a person’s behavior.
- Psychiatrists may help those who have a coexisting mental health disorder.
- A therapist or counselor provides therapy for mental health difficulties.
Different Types of Therapy
One of the most important parts of the treatment plan for someone with cerebral palsy is the use of different therapies to teach skills and compensate for the challenges the condition presents. (1)
- Physical therapy focuses on improving a person’s muscle strength, balance, and motor skills. It involves stretching, strength and conditioning workouts, swimming, and other activities specially designed to improve certain muscle groups.
- Occupational therapy helps people do the most they can, especially with the upper body, so they can get dressed, maintain personal hygiene, care for themselves, eat, do school or work activities, and complete other necessary daily skills.
- Speech and language therapy not only help with verbal communication but can also assist a person with any swallowing difficulties. For those who cannot speak or have trouble speaking, speech and language therapy may actually focus on finding other ways to communicate effectively with others.
- Recreational therapy uses involvement in sports, cultural, and artistic activities. It helps a person’s mind and body stay sharp, and promotes social skills, self-esteem, and overall well-being.
Medications Taken for Cerebral Palsy
A variety of medications treat different problems caused by cerebral palsy, including muscle and neurological problems, psychiatric conditions, and gastrointestinal conditions.
The medications for psychiatric, seizure, or gastrointestinal problems are the same as those used for any other person with those conditions. For example, a person with a seizure disorder such as epilepsy will take one of the standard anti-epileptic drugs that others with seizure disorder would be prescribed. A person’s psychiatric prescriptions will depend on their particular condition and difficulties.
The first-line drugs used to adjust a person’s muscle tone, tamp down spasticity, or otherwise manage stiff, contracted, or overactive muscles include diazepam (Valium), baclofen (Lioresal), dantrolene (Dantrium), and tizanidine (Zanaflex). (2)
Most of those medications are oral, but some medications require a different delivery method.
Botulinum toxin (Botox) is a substance that relaxes overactive muscles by settling down the nerve cells that control them. The effects of a botulinum toxin injection last about three months in most people. This therapy is best paired with physical therapy that involves stretching and splints.
The drug baclofen is a muscle relaxant that can be taken as a pill or administered through intrathecal baclofen therapy, in which a pump is implanted into a person’s body, and the drug is released into the spinal fluid. The pump can be adjusted to account for times when symptoms are better or worse.
Side Effects From Drugs
All drugs have the risk of side effects in some people who take them. Those taking these drugs may therefore need ongoing monitoring in case some of the more dangerous side effects occur, such as changes in blood pressure and liver damage.
Other side effects, such as drowsiness, do not require monitoring, but a person and his caregivers should be aware of them in case they interfere with daily activities.
Botulinum toxin causes pain at the injection site and may cause symptoms similar to the flu, such as fever, chills, and aches, but these symptoms usually pass within a few days.
Surgery for Spasticity and Other Abnormalities
Several types of surgery can help people with cerebral palsy. But since most surgeries are not reversible, it’s important to discuss with a doctor not only how a specific surgery may offer benefits, but also the possible long-term risks.
Orthopedic surgery involves correcting spinal abnormalities or lengthening contracted muscles and tendons to reduce pain and improve walking and overall movement. However, tendon-lengthening can result in long-term weakness in some people. (3)
People with severe spasticity or chronic pain who have exhausted all other treatment options may consider selective dorsal rhizotomy (SDR). This surgery cuts overactivated nerves at the base of the spine, in a limb, or near the bladder. Severing nerves can cause loss of feeling, numbness, or persistent discomfort in the body areas once served by the severed nerves. (1)
Eye surgery can correct problems such as cataracts or overactive eye muscles that prevent a person from controlling her eye movements.
Surgery to remove certain sections of the brain may help reduce seizures. Another option is vagal nerve stimulation, in which a device implanted in the brain works directly on the nerves to reduce seizures.
Assistive Devices for Communicating, Mobility, Seeing, and Hearing
A variety of tools can help people with cerebral palsy meet their needs. Those who struggle with communication may rely on computers, voice synthesizers, picture books, and specialized software. (4)
Orthotic devices help a person stand, balance, or move more easily. They include braces or splints that improve a person’s ability to walk or sit. If orthotics do not fully meet a person’s needs, they may use other devices for getting around, such as wheelchairs, walkers, or powered scooters.
People with vision problems may rely on glasses, magnifying devices, audiobooks, and books or a computer with large print or fonts. Hearing aids and amplifiers for phones assist with hearing problems.