Cerebral Palsy Treatment

"Management" is a better word than "treatment." Management consists of helping the child achieve maximum potential in growth and development. This should be started as early as possible with identification of the very young child who may have a developmental brain disorder. A management program can then be started promptly wherein programs, physicians, therapists, educators, nurses, social workers, and other professionals assist the family as well as the child. Certain medications, surgery, and braces may be used to improve nerve and muscle coordination and prevent or minimize dysfunction.

As individuals mature, they may require support services such as personal assistance services, continuing therapy, educational and vocational training, independent living services, counseling, transportation, recreation/leisure programs, and employment opportunities, all essential to the developing adult. People with cerebral palsy can go to school, have jobs, get married, raise families, and live in homes of their own. Most of all people with cerebral palsy need the opportunity for independence and full inclusion in our society.

Unfortunately, no miracle treatment exists that can erase the symptoms of Cerebral Palsy. There are, however, many therapeutic options that can maximize the physical and mental potential of an afflicted child.

Physical therapy usually begins soon after the diagnosis is made, during the first few years of life. The programs use specific sets of exercises to work towards preventing the weakening or deterioration of muscles that can result from a lack of use and to avoid contracture. Contracture, when muscles become fixed in rigid, abnormal positions, is one of the most common and serous complications with Cerebral Palsy. Spasticity prevents stretching of the body’s muscles and tendons so muscles do not grow fast enough to keep up with lengthening bones. Normally, a child’s bones that are growing stretches the muscles and tendons through daily movement and other activities.

With Cerebral Palsy the contracture can disrupt balance and set off loss of previous abilities. Physical therapy is used to prevent this complication by stretching spastic muscles. Some physical therapy programs work to improve motor development as well. In addition, behavioral therapy uses psychological theory and techniques. This can be used to complement physical, speech, or occupational therapy.

Drug therapy is used for those who have seizures associated with having Cerebral Palsy. The medication is very effective in preventing seizures for many of the patients. Drugs are also used to control spasticity in some cases. Medications used most often are diazepam, a general relaxant of the brain and body, baclofen, blocks signal sent from the spinal cord to contract the muscles, and datrolene, interferes with the process of muscle contraction. These drugs are used for short periods but long-term control of spasticity has not been demonstrated clearly yet.

Athetoid Cerebral Palsy patients are sometimes given drugs to help reduce abnormal movements, usually treated by chemicals called anticholinergics. This chemical reduces the activity of acetylcholine, a chemical messenger that helps some brain cells communicate and triggers muscle contraction. Physicians may use injections of alcohol into a muscle to reduce spasticity for a short period. By doing this to a muscle that is too short physicians can work on lengthening the muscle when it becomes weakened for weeks from the alcohol.

Surgery is used when contractures are severe enough to create problems in movement. The surgeons lengthen the muscle that is too short. Lengthening a muscle usually makes it weaker so surgery for contractures is usually followed by recovery months. To reduce spasticity in the legs, surgery called selective dorsal root rhizotomy is used. It reduces the amount of stimulation that reaches leg muscles by the nerves. The effectiveness of this surgery is continually being researched.

A newer device, being the computer, can make a significant difference in the life of someone with Cerebral Palsy. Children can learn to control a computer and communicate with others. A special light pointer attaches to a headband, along with the computer and voice synthesizer.

Treatment for Erbs Palsy, or Brachial Plexus Injuries, include exercise and therapy or surgery plus therapy. Children who do not recover by 5 months old may benefit from surgery. Nerve surgery is performed to improve how well the arm functions. The surgery is most effective when done when the child is between the ages of 5 and 12 months. After one year old, the surgery may not be as successful. Surgery is not always recommended and is not always successful.

Daily exercises can help to keep the muscles and joints moving normally and prevent joints from “freezing”. Therapists will work with the child to do the exercises.