Unfortunately, cerebral palsy is incurable. However, there are many treatments available to improve your child’s quality of life and ability to live independently. Treatment for cerebral palsy may include surgery, assistive devices, various types of therapy, medications, and treatments for other conditions associated with cerebral palsy. You’ll need to work with your child’s doctor to determine what course of treatment will be best for your child’s unique needs, but let’s take a look at the basics of treatment.
Some children with cerebral palsy may require surgery in order to walk or stand normally. Cerebral palsy can cause the muscles and tendons in the legs to be unusually short or tight, which may be painful and may cause the child to walk on his/her toes. Orthopedic surgery can lengthen and loosen those tendons and muscles, allowing the child to have a more comfortable and functional gait.
Cerebral palsy can also cause deformities of the spine. In some cases, orthopedic surgery is a good option for straightening and correcting the spine. Straightening the spine can relieve abnormal joint pressure and make walking easier.
In some very severe cases where other treatment methods have been ineffective, children may benefit from a procedure called “selective dorsal rhizotomy.” In this procedure, the surgeon severs certain overactive nerves at the base of the spinal column. This stops the muscles from spasming uncontrollably and can significantly decrease the child’s pain and discomfort. However, the surgery is risky and can cause side effects including numbness and loss of sensation in the limb to which the severed nerves were connected.
Finally, some children may need surgery to correct the vision problems associated with cerebral palsy, especially strabismus (cross eyes).
Orthotic devices may help children with cerebral palsy increase their mobility and compensate for balance and coordination problems. These devices may include braces or splints for the limbs to straighten them and properly align the muscles. Other types of braces may be used to help stretch and loosen tight muscles, easing pain and making movement easier. If your child is not mobile, he/she may use a walker, scooter, or wheelchair to get around.
Children with cerebral palsy may benefit from several different types of therapy. Physical therapy is one of the most powerful tools used to treat cerebral palsy and often begins when the child is still very young. Physical therapy will focus on strength training, coordination, and balance. It may also include more passive types of therapy, such as application of heat or cold to the muscles. Your physical therapist may make use of various orthotic devices to help stretch or align your child’s muscles. The specific course and content of physical therapy will depend on your child’s unique needs but is generally designed to increase coordination and mobility, strengthen and align the muscles to reduce pain and increase coordination, increase fitness, improve posture, and psychologically encourage the child.
Cerebral palsy sufferers may also benefit from occupational therapy. Occupational therapy typically focuses on making everyday tasks manageable. It may include learning how to dress, finding ways to get in and out of cars comfortably, and working out strategies for other tasks that are difficult for those with impaired mobility and muscle control. It may also involve learning how to set up a living space that meets the needs of your child, making the space safe and ensuring important items are within easy reach.
Many children with cerebral palsy suffer from some form of speech impediment. This is caused by difficulty controlling the muscles used in speech and, in some cases, may be exacerbated by intellectual disabilities. Children with a speech impediment may benefit from speech therapy. Speech therapy focuses on increasing and improving control of those muscles to make speech easier. It may also include strategies for communicating more clearly, using gestures or sign language. In some cases, children may learn to use a set of pictures of common objects or a computer with a voice synthesizer to ease communication.
Some speech therapy programs can also help children increase control over the muscles controlling swallowing, drooling, and eating. Children with poor control over those muscles are at risk for aspirating food or liquid into their lungs, causing serious infections and breathing problems. Therapy can help children strengthen those muscles and swallow properly.
Finally, children with cerebral palsy may benefit from recreational therapy. This type of therapy is focused on the wellbeing and happiness of the child and often involves art, sports, cultural activities, and other exercises to broaden the child’s physical and emotional horizons. Recreation therapy can also benefit children in other aspects of their treatment, improving speech, mobility, and self-esteem.
A number of medications can help soothe and relax your child’s stiff, sore, contracted muscles. These include baclofen, dantrolene sodium, tizanidine, diazepam, and others. In some severe cases, children may benefit from an implanted baclofen pump that delivers the drug straight to the spinal cord. Most of the drugs have mild side effects, but some may cause drowsiness. More serious side effects include liver damage and changes in blood pressure. Discuss the options and risks with your child’s doctors when considering oral medications to treat cerebral palsy.
More recently, some doctors have been treating cerebral palsy patients with botulinum toxin – the same type used in Botox cosmetic treatments. Botulinum toxin (BT-A) impairs the function of the nerves that cause muscle spasms and can offer relief for several months at a time. It’s not permanent and must be administered several times a year. This treatment is typically most effective where only a few muscles are affected by relatively mild cerebral palsy.
Cerebral palsy is associated with a number of other conditions, including epilepsy, incontinence, osteoarthritis, bone loss, and chronic pain. Treatment of your child’s cerebral palsy may involve treatment for these secondary conditions, as well. All of these conditions may be treated with medication. Your child may also work on control of her bladder muscles to reduce incontinence over the course of her therapy.