At present, there is no cure for cerebral palsy. However, there are numerous treatments available that may treat the symptoms associated with cerebral palsy and help improve life span and quality of life of individuals with cerebral palsy. These therapies may help by easing symptoms such as spasticity, improving communication skills and improving self-care and independence.
Treatment of cerebral palsy requires a multidisciplinary approach from developmental neurologists, physiotherapists, speech and language therapists, occupational therapists as well as psychologists. An individual care plan is often put in place and is constantly reassessed as symptoms improve or a patients’ needs change over time.
Physiotherapy is normally started as soon as the diagnosis is made, and is usually the most important treatment strategy for cerebral palsy. There are three main goals of physiotherapy. Firstly, to prevent the weakening of muscles that are not normally used and increase strength. The second is to prevent muscles getting stuck in a rigid position, known as contractures, which are usually quite painful and can affect normal development. The third goal is to encourage more movement. Physiotherapists usually teach children with cerebral palsy several exercises that they can carry out every day to strengthen and stretch their muscles. In addition, arm or leg braces may also be used to facilitate the support of limbs.
Speech and language therapy can help children with cerebral palsy develop their facial muscles with regular facial exercises. As these muscles strengthen over time, It can also help with eating, drinking, and swallowing. Speech and language therapy may also help the child to speak clearly if their condition is not too severe. If their communication difficulties are severe, the therapist may be able to teach them an alternative method of communication, such as sign language or via a computer that can generate speech. Some children may be able to communicate using personal computer devices using pictures and symbols.
Medications can be administered to relieve various physiological symptoms of cerebral palsy. This may involve individual medications to help treat specific symptoms, or a cocktail of a combination of medicines if the condition is severe.
Baclofen is helpful in relieving muscle stiffness. It is usually given orally as pills, however it may also be given through a pump inserted within the skin so that the medication can directly be administered into the spine.
Botulinum toxin may also be administered directly into spastic muscles to relieve spasticity for several months at a time.
Other general use medications such as laxatives for constipation or anti-epileptic medication if there are seizures can also be given.
As with most medications, if side effects appear or persist, the physician may be able to replace the medication with a more suitable one, or use an alternative therapy.
Surgical therapy is needed at times to correct movement problems and contractures. These surgeries help in easing tight muscle tone and restore normal structure. Surgery is often a last resort option with patients with the severest symtpoms. Surgeries that are undertaken include:
- repair of hip dislocation and the curvature of spine (scoliosis)
- lengthening of tendons and muscles to reduce muscle spasticity and contractures
- removal of part of the bone to position and realign a limb
- selective posterior rhizotomy that involves operating on nerve roots coming from the spinal cord to ease muscle stiffness in the legs
In conjunction with surgery, more occupational therapy (developing skills to perform everyday tasks such as dressing oneself) and physiotherapy is usually required to achieve the best long lasting results. This can take several months to a couple of years to be fully achieved. During this time medication may also be administered.
Several mobility aids are used to improve movement and mobility. This includes orthotic devices, wheelchairs and powered mobility walkers. Physical methods of spasticity relief can include heat, cold and vibration methods.
In summary, there is no cure for cerebral palsy at present, however there are various surgical, therapeutic and medicinal treatments for the symptoms and physical characteristics of cerebral palsy. Whilst these may not cure the condition, they may help ease the symptoms. Used in combination with one and another, a multidisciplinary approach is the best approach to treating cerebral palsy, especially if started at the earliest age possible.