Medication
and cerebral palsy
Medications used for cerebral palsy could have many therapeutic benefits for your child or loved one. They could improve their quality of life, their ability to move independently, and their physical growth and development. Learn more about the different forms and methods of cerebral palsy medications that you may encounter as part of your child’s or loved one’s treatment plan.
The Role of Medication in Treating Cerebral Palsy
There are many kinds of medications that your physician may prescribe for your child’s CP. Depending on your child’s or loved one’s unique form of cerebral palsy, your physician may prescribe one specific medication or a combination of medications. Some factors your physician may take into consideration include:
- Spasticity: Your physician may determine that one or more specific medications could improve spasticity or hypertonia.
- Pain: Some children experience acute or chronic pain. Children with spastic CP often experience worse pain than those with other types of cerebral palsy. Pain is most commonly concentrated in the hips, knees, ankles and back.
- Seizures: If your child experiences epileptic seizures due to their cerebral palsy, your physician may prescribe certain medications to reduce or prevent them.
Types of Medications
Oral Medications
Doctors often prescribe oral medications first to relax stiff, contracted, or overactive muscles. Oral medications are best for children who need only a mild reduction in muscle tone or who have widespread spasticity. Some drugs come with the risk of side effects that require monitoring. Be sure to consult with your doctor or pharmacist.
Antispasticity medications are divided into two groups: antispasmodics and antispastics. Antispasmodics are used to treat muscle spasms, and antispastics are used to treat muscle spasticity.
Skeletal muscle relaxants are commonly used to treat two different types of conditions: spasticity from upper motor neuron syndromes and muscular pain or spasms from peripheral musculoskeletal conditions. Some of these medications work in the brain to reduce excessive nerve activity, while others act directly on muscles.
Antispastics help reduce muscle spasticity in patients (and are not used to treat muscle spasms). There are several types of antispastics available:
- Muscle relaxants: “Muscle relaxants” are actually not a class of drugs, but this umbrella term covers a variety of different drugs that have an overall sedative effect. Muscle-relaxing drugs, such as baclofen, diazepam, and dantrolene may be prescribed to reduce spasticity. All of these drugs can be taken by mouth, but baclofen may also be injected directly into the cerebrospinal fluid through an implanted pump.
- Dopaminergic drugs: This medication, commonly used to treat Parkinson’s disease, raises the body’s dopamine levels, leading to less rigidity and better muscle control.
- Dantrolene (Dantrium): Dantrolene helps control chronic spasticity, including that related to spinal injuries. It is also used for conditions such as multiple sclerosis and cerebral palsy. Dantrolene is taken as a capsule.
- Benzodiazepines: Benzodiazepines are used to control muscle spasms and to provide sedation. Barbiturates and benzodiazepines alter GABA receptors, which are the major inhibitory neurotransmitter receptors in the brain. Dantrolene and baclofen may also be considered for severe spasticity. Relaxants, such as Valium, work on the brain to ease certain CP conditions. Other examples of oral benzodiazepines are Xanax, Ativan, Librium, and Klonopin.
- Glycopyrrolates: This medication is used to treat sialorrhea (excessive drooling).
- Carbamazepines: Antiepileptic drugs (AEDs) decrease the frequency and/or severity of seizures. You may also hear the outdated term “anticonvulsants,” which is still sometimes used as a synonym for AED but is less accurate because many seizures do not involve convulsive movements.
- Proton Pump Inhibitors (PPIs): Introduced for treatment of gastrointestinal disease, PPIs suppress acid and are used for the treatment of peptic ulcer disease and for severe GERD not responding to other therapy. Several PPIs—Prilosec, Prevacid and Aciphex—are now marketed for GERD. PPIs were initially recommended for short-term use.
Injectable Medications
Botulinum toxin (Botox) is often used to relieve hypertonia in a specific area of the body because its effects are local, not body wide. It is a neurotoxin, which works by weakening spastic muscles, causing them to relax. Injected locally, Botox has become a standard treatment in children with spastic movement disorders such as CP.
Intrathecal Medications
Intrathecal baclofen therapy uses an implantable pump to deliver baclofen, a muscle relaxant, into the fluid surrounding the spinal cord. Baclofen decreases the excitability of nerve cells in the spinal cord, which then reduces muscle spasticity throughout the body. The pump can be adjusted if muscle tone is worse at certain times of the day or night. The baclofen pump is most appropriate for individuals with chronic severe stiffness or uncontrolled muscle movement throughout the body.
Questions To Ask Your Doctor
When you visit your physician to introduce a new medication, there are several things you need to know. From proper dosages and administering medications before bedtime to concerns about side effects and the medication’s effectiveness, be ready to talk about these aspects of your child’s treatment plan. We have included some considerations you could bring up with your physician the next time you visit.
Dosage and Time
Ask your physician about the best times to administer medications and how to ensure the dosage is working. If you have any concerns about dosages, bring it up to your doctor.
Side Effects
Learn about any side effects you should be aware of before giving your child a new medication. Take note of any side effects that could warrant concern and what you can do if you notice these effects.
Contraindications
If your child is taking multiple medications prescribed by different physicians, you should be sure that prescribers are considering all medications and possible interactions. It’s worth verifying that new medications are compatible with current prescriptions before administering them.
Dietary Restrictions
In the case of prescription medications, ask your physician if there are any foods that should be avoided while taking the medication. Some medications need to be taken on an empty stomach, while others may need to be taken with food.
Duration
Ask your doctor how long your child will be on the medication and how long it usually takes to see the effects.
Effectiveness
Learn about what you can do if the dose isn’t effective. You may need to call your doctor or schedule a follow-up visit if the medication doesn’t seem to be working as intended.
Monitoring
Ask whether blood work is needed to monitor therapeutic medication levels or other functions, such as liver or kidney functions, which may be indirectly impacted by the medication. If necessary, ask how often such blood work or monitoring will be needed.
Procedures
Discuss with your physician any other procedures or evaluations that will be needed to monitor medication levels and organ functions. Find out whether your child will need routine blood work or other evaluations to monitor their medications.
Injectable Medications
For injectable medications, ask what you can provide for pain relief, if needed, for the injection site or other discomfort post-treatment.
Is Medication Necessary?
When considering any medical intervention for your child—whether it be prescription medications, therapy, or surgery—it is important to do your research regarding both potential benefits and side effects. In many cases, medication may not be necessary but may help alleviate some of the main symptoms with which your child and your family are struggling.
Advice should always be obtained through consultation with a physician who has examined your child and is familiar with your child’s medical history. Discuss your goals, your expectations regarding quality of life, and any concerns you have regarding the medication and its potential side effects.
If you suspect that your child’s CP was the result of a preventable medical error, call the experienced Cerebral Palsy Family Lawyers at Janet, Janet & Suggs, who have helped more than 30,000 families nationwide over the past 40+ years. They will answer your legal questions, discuss your legal rights and options, and consult with you regarding potential next steps in your case. Contact us today to let us help you and your family seek the justice and compensation you deserve.
