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Prevention and Medication
The cause of cerebral palsy (CP) sometimes is not known. However, links have been identified between CP and certain conditions during pregnancy, birth, and early childhood. Some of these can be prevented; some cannot.
You can help prevent CP before and during your pregnancy by adopting and maintaining healthy habits.
* Eat nutritious foods.
* Do not smoke.
* Avoid exposure to harmful substances.
* See your health professional regularly.
Also, help prevent CP in your young child by minimizing your child's risk for sustaining a brain injury.
* Take measures to prevent accidents.
* Make sure you are familiar with the signs of jaundice in newborns.
* Know how to prevent lead poisoning.
* Keep your child away from people who have serious contagious illnesses, such as meningitis.
* Make sure your child's immunizations are up to date. For more information, see the topic Immunizations.
Medications can help control some of the symptoms of cerebral palsy (CP), prevent or minimize complications, and treat other medical conditions related to CP.
Antispasmodics are the most common medications used for people with CP. Antispasmodics can help relax tight muscles and reduce muscle spasms. Most antispasmodics are taken orally and include:
* Diazepam (such as Valium).
* Baclofen (Lioresal).
* Dantrolene sodium (Dantrium).
Although these medications are given as a pill to swallow (oral medication), baclofen can also be given using a method called intrathecal baclofen (ITB). For this, a small pump is placed under the skin of the abdomen. This pump releases baclofen into the fluid around the spinal cord. ITB may be more helpful than taking a pill at relieving severe spasms; however, it is harder to do than pills, and has some risks (such as infection where the pump is implanted.)
Injectable antispasmodics, which are injected directly into stiff or spasmatic muscles, are occasionally used to help them relax. They typically remain effective for about 3 to 8 months, depending on the type used. Injectable antispasmodics used for treating CP include:
* Phenol or alcohol "washes."
* Botulinum toxin (Botox).
Anticonvulsants are used as treatment for people with CP who have seizures. Most commonly used anticonvulsants include:
* Topiramate (Topamax).
* Lamotrigine (Lamictal).
* Oxcarbazepine (Trileptal).
* Zonisamide (Zonegran).
* Gabapentin (Neurontin).
Anticholinergics help a minority of people with CP who have uncontrollable body movements (dystonic cerebral palsy) or who drool frequently. These include:
* Trihexyphenidyl hydrochloride (Artane).
* Benztropine mesylate (Cogentin).
* Carbidopa-levodopa (Sinemet).
* Procyclidine hydrochloride (Kemadrin).
* Glycopyrrolate (Robinul).
Stool softeners and mild laxatives may help treat constipation, which is a common complaint of people with CP.
What To Think About
Medication for cerebral palsy (CP) targets individual needs. Unfortunately, medication has had limited success in treating CP, especially the types that involve involuntary movements (athetoid type of dyskinetic cerebral palsy).
Some medications used to treat CP have serious side effects. For example, dantrolene sodium (Dantrium) can cause liver damage; frequent blood tests are needed while taking this medication.
Some health professionals believe that the most commonly used medications to treat CP (diazepam [such as Valium], baclofen [Lioresal], and dantrolene [Dantrium]) should not be given to growing children. They are concerned that the side effects from these medications can cause problems for children that are more severe than the tight muscles and muscle spasms related to CP. For example, one side effect of these medications is drowsiness. Drowsiness may interfere with a child's ability to concentrate and learn in school. Other health professionals believe that the benefits of these medications outweigh the risk of side effects.
Ask your doctor the following questions about any medication prescribed for your child:
* How successful is the medication in treating your child's problem?
* What are the short-term and long-term side effects of the medication?
* What are the chances that the medication will stop working? Discuss what options are available if this happens.
* How might the medication affect your child's growth and development?
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