Cerebral Palsy

Treatment

Cerebral palsy, although not curable, does not worsen over time. However, complications may arise related to abnormal muscle tone and other issues. Treatment aims to improve quality of life, enhance participation socially and academically in school, increase strength, facilitate personal hygiene, reduce disabilities, and prevent complications, such as slowed growth and joint problems. The plan of care depends on the needs and condition of each child and may include:

Physical Therapy: This is one of the most important therapies for people with cerebral palsy. Muscle training and exercises may improve strength, balance and mobility and lead to greater independence. Stretching is one component of a program that may help slow the formation of contractures (limitation of joint range of motion). Physical therapy may begin as soon as a muscle tone abnormality or developmental delay is detected and may continue for years. Specialists assist with recommendations regarding wheelchairs and other mobility devices when needed.

Medications: Medications may relax tight muscles and reduce tremors and muscle spasms. Injectable medications such as Botox or phenol may be used to reduce areas of muscle spasticity. People who have seizures also may need antiseizure (anticonvulsant) medications. If other medical conditions are present, additional medications may be necessary.

Orthotic Devices: For children with cerebral palsy, muscles do not grow fast enough to keep pace with lengthening bones. The resulting contracture can disrupt balance and trigger loss of abilities. Special braces (orthotic devices) combined with physical therapy and other interventions may prevent this complication by stretching spastic muscles.

Surgery: Surgery may help loosen tight or stiff muscles or correct problems such as curvature of the spine or uneven leg growth. To decrease spasticity, a surgeon can implant a pump to deliver medications to the spinal cord or sever nerve roots (rhizotomy) that contribute to increased muscle tone.

A child may need surgery on muscles, tendons, nerves or joints to place his or her arms and legs in their correct positions. Surgery can help facilitate sitting or walking, improving a child's ability to use the hands, decreasing pain, easing care issues for families and avoiding future surgeries.

Surgery may also be used to place feeding tubes and to control gastroesophageal reflux. Recently, botulinum toxin injections have been used to reduce or delay the need for surgery.

Occupational Therapy: This therapy often focuses on developing a child's hand function, hand skills and self-care skills. Feeding and swallowing problems may be addressed. Occupational therapists also have expertise regarding special equipment that can benefit a child in daily living, school and mobility.

Speech Therapy: Speech therapists can help children improve their speech and language skills or use of alternative means of communication.

Hearing Aid: Children and adults can benefit from hearing aids.

Eyeglasses or Eye Surgery: If glasses are not sufficient to correct a child's vision problems, surgery may be used to correct cross-eye or inability of the eyes to focus together properly (strabismus).