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Physical therapy usually begins shortly after the diagnosis is made. Specific exercises are used in physical therapy to prevent the weakening or deterioration of muscles from disuse (disuse atrophy) and to avoid muscle contracture (muscles fixed in a rigid, abnormal position).

Contracture is one of the most common and serious complications of cerebral palsy and can seriously disrupt balance. Activities such as running and walking in child whose bones are growing stretch the body's muscles and tendons. As a result, muscles generally grow at the same rate as the growing bones. In children with cerebral palsy, spasticity prevents the body's muscles from stretching so that the muscles do not grow fast enough to keep up with the growing bones.

As children approach school age, physical therapy will help the child by improving his or her ability to sit, and to move independently or in a wheelchair. Many children benefit from occupational therapy which helps the child to develop such skills as feeding, dressing, or using the bathroom. Speech therapy works to identify specific difficulties a child with cerebral palsy may have or to help the child, if necessary to learn to use special communication devices.

Behavioral therapy uses psychological theory and techniques to assist the child with cerebral palsy with his or her physical, speech, or occupational therapy.

Vocational training, recreation programs and special education may be necessary as a child with cerebral palsy grows older. Adults may need assistance with living accommodations, and transportation.

Counseling for emotional and psychological challenges may be needed at any age, most often during adolescence.

DRUG THERAPY

Drug Therapy is necessary for those who have seizures associated with cerebral palsy, and may be effective in preventing seizures in many patients.

Drugs may be used to control spasticity for short periods of time. Generally the medications used most often are those which act as a general relaxant of the brain and body (diazepam); which block signals sent from the spinal cord to contract the muscles (baclofen); and which interfere with the process of muscle contraction (dantrolene). The use of drugs may cause serious side effects, such as drowsiness, and their long-term effects on the developing nervous system are largely unknown.

Drugs may help reduce abnormal movements in patients with athetoid cerebral palsy. The drugs most often prescribed are anticholinergics. These drugs work by reducing the activity of acetylcholine, a chemical messenger that helps some brain cells communicate, and that trigger muscle contraction.

What's the treatment for cerebral palsy?

There is no cure for cerebral palsy, but various forms of therapy can help a person with the disorder to function more effectively. Comprehensive treatment of cerebral palsy requires a multidisciplinary team approach to help maximize and coordinate movement, minimize discomfort and pain, and prevent long-term complications. This team may include a neurologist, an orthopedist, and physical, speech and occupational therapists. In addition, social workers can provide

support to families and help to identify private and community resources. Most children with cerebral palsy benefit from early and regular physical and occupational therapy. Some children need braces and supports to help them stand and walk; surgical procedures, such as tendon releases or bone surgery (especially on hips and spine); and treatments to reduce spasticity.

Treatment for a child with CP depends on the severity, nature, and location of the impairment, as well as the associated problems the child has. Optimal care of a child with mild CP may involve regular interaction with only a physical therapist and occupational therapist, whereas care for a more severely affected child may include a speech-language therapist, special education teacher, adaptive sports therapist, nutritionist, orthopedic surgeon, and neurosurgeon. Since CP is not a progressive disorder, its symptoms will not worsen with time. Nonetheless, the way in which those symptoms affect the growing child will change over time, and may require new strategies for treatment, adaptation, and compensation.

Parents of a child newly diagnosed with CP are not likely to have the necessary expertise to coordinate the full range of care their child will need. Although knowledgeable and caring medical professionals are indispensable for developing a care plan, a potentially more important source of information and advice is other parents who have dealt with the same set of difficulties. Support groups of parents of physically or mentally impaired children can be significant sources of both practical advice and emotional support. Many cities have support groups that can be located through the United Cerebral Palsy Association or a local hospital or social service agency. Children with CP are also eligible for special education services. The diagnosing doctor should refer parents to the local school district for these services. Even children aged 0'3 years are eligible through "early intervention."