While there is currently no cure for cerebral palsy (CP), there are many different treatment options that can help individuals and families better manage this category of neurological diseases.
Before going into what those options are, it’s important to understand that, unlike with other less-severe medical conditions, individuals with CP often require the care of an entire team to help them better manage this disease.
A Team-Based CP Response
The exact members of this team are largely determined by the patient’s type of CP and its severity. Mayo Clinic explains that the team may include any or all of the following:
- Pediatrician – doctor trained to treat infants and children
- Physiatrist – physician trained in medical conditions related to the brain, nerves, and musculoskeletal system; also known as Physical Medicine and Rehabilitation (PM&R) specialist
- Pediatric Neurologist – doctor who specializes in treating children and disorders related to the brain and nervous system
- Orthopedic Surgeon – specialist offering surgical treatment options related to the muscles
- Physical Therapist – therapist who provides exercises and activities designed to help the patients experience improvements in strength, flexibility, balance, and coordination
- Occupational Therapist – therapist who assists the patient with learning how to engage in and successfully complete day-to-day activities
- Speech-Language Pathologist – doctor who works to help CP patients overcome issues related to speech and language, as well as swallowing difficulties
- Developmental Therapist – therapist who aids in the learning of age-appropriate skills and behaviors
- Psychologist – mental health doctor who helps patients manage any emotional or psychological issues, as well as teaching effective coping mechanisms to better deal with the disease
- Psychiatrist – mental health doctor who performs duties similar to a psychologist, but can also prescribe medications
- Recreation Therapist – therapist who assists CP patients with participation in recreational activities, such as sports and art-based programs
- Special Education Teacher – a teacher specially trained to work with students who have physical and/or mental differences
- Social Worker – community-oriented professional who can help connect you with local resources for CP care and treatment
Therapy-Based Cerebral Palsy Treatment Options
There is no one-size-fits-all solution for all CP patients. The type of treatment more likely to provide the best results depends on which type of CP the patient has, and its level of severity.
However, the best treatment regimen is often one that incorporates a mixture of several different therapies designed to treat the symptoms common with this particular disease. Here are a few to consider.
The National Institute of Neurological Disorders and Stroke refers to physical therapy as “a cornerstone of CP treatment,” which involves the patient performing exercises and activities in an effort to improve balance, coordination, and muscle tone.
Engaging in physical therapy can also help ease muscle contractions experienced by individuals with CP.
Occupational therapy differs from physical therapy because it focuses on helping individuals with CP learn different ways to complete everyday activities related to self-care, work functionality, and recreational events and experiences.
This form of therapy generally involves working with the patient on skills such as getting ready in the morning, managing work or school duties, and other actions the patient would normally take part in on a typical day.
Participation in recreation therapy includes everything from engaging in sports to horseback riding to participation in art-based programs, and it is another type of treatment that can help individuals with cerebral palsy.
The Cerebral Palsy Group shares that its benefits are both mental and physical and often include:
- Improvements in coordination, flexibility, and strength
- Decreased feelings of anxiety and anger
- Better social skills with decreased social isolation
- Enhanced body image and self-confidence
- Improved feelings of well-being
- Improvements in behavior
Speech & Language Therapy
If the CP patient experiences difficulty with speaking, then speech and language therapy can help him or her learn how to communicate as efficiently and effectively as possible given the type of CP and its severity. This may require learning sign language or helping the patient learn how to use assistive devices such as voice synthesizers or picture boards.
A speech and language therapist may also help cerebral palsy patients address any issues they may have when swallowing or eating.
Medications for Cerebral Palsy
Some medications have been found to help ease cerebral palsy symptoms. Many address tightness of the muscles, helping them to relax enough to reduce the symptoms characterized by this disease while also decreasing any existing pain.
The medication prescribed for CP depends on the type. Additionally, these medications may be administered orally (in pill form) or via an injection.
The Mayo Clinic indicates that if the patient has generalized spasticity that impacts the entire body, some of the most commonly prescribed drugs are:
- Diazepam (Valium)
- Dantrolene (Dantrium)
- Baclofen (Gablofen)
However, if the patient has isolated spasticity, which is when only one muscle group has jerky movements, onabotulinumtoxinA (Botox) injections are often recommended.
If the cerebral palsy causes the individual to drool, various medications can be prescribed to help with this. These include:
Botox injections in the salivary glands may also help reduce drooling.
The one concern with medications is their possible side effects. For instance, dantrolene can cause drowsiness, weakness, nausea, and diarrhea, and Botox injections may result in pain, flu-like symptoms, and even difficulty swallowing or breathing.
The side effects must be weighed against the benefits when determining whether to take this particular treatment route.
Orthotic & Other Helpful Devices
Some cerebral palsy patients find that orthotics and other devices can help with movement.
For instance, braces and splints can help support them when engaged in physical activities such as walking. These types of devices may also provide relief when the patient is stationary by helping stretch or straighten stiff and tight muscles.
CP patients may also find value in other movement-related aids such as canes, walkers, crutches, seating systems, or wheelchairs.
These devices can be used in conjunction with other types of therapies, or to assist with better movement following surgery.
Surgical Options for CP Patients
In cases where the individual with CP has severe muscle contractions, deformities, or pain, surgery may be recommended. The type of surgery depends on which issue(s) the specialist is attempting to correct.
- Orthopedic surgery may be recommended on the bones or joints so the patient’s arms or legs are in healthier alignments. It may also be used to lengthen muscles and/or tendons in an effort to reduce pain and give the patient more mobility.
- Another surgery that sometimes helps patients with cerebral palsy is selective dorsal rhizotomy. This surgery involves the physician cutting nerves in the spinal column to reduce pain and relax the spastic muscles. In some cases, this surgery may result in numbness.
- A neurectomy requires cutting of the nerves to help better control muscle groups experiencing spasticity or tightness. This type of surgery is often used in cases where the patient has hip dislocation.
- A tenotomy is a surgery that involves cutting the tendons, and a myotomoy involves cutting the muscles. Either of these may be performed to prevent permanent tightness to these areas (known as contractures).
- Other types of surgery may be recommended to move tendons from one bone to another to create better alignment, which is called a tendon transfer.
- Another surgery could be suggested to remove part of the bone to better align the joints, called an osteotomy.
- Arthrodesis is a surgical option that involves the surgeon fusing bones together to improve stability.
Complementary and Alternative CP Therapies
Research has found that many CP patients and their families seek natural options for treating this type of disease.
In fact, a review published in Developmental Medicine & Child Neurology reported that 38 percent of the respondents in a study conducted by the Centers for Disease Control and Prevention (CDC) admitted to engaging in at least one form of complementary and alternative method, often referred to as CAM for short.
Their reason for choosing CAM was not that they were unhappy with the care they received, but because they were looking for a natural type of treatment they could combine with or use as a supplement to their other treatment methods.
A few CAM options relevant to individuals with CP include:
- Yoga and meditation to relax the muscles and lower stress
- Acupuncture to restore the normal flow of energy, often referred to as Qi or Chi
- Threshold electrical stimulation to increase blood flow to strengthen muscle tone
- Craniosacral therapy, a touch therapy designed to manipulate the joints of the cranium to improve the flow of cerebrospinal fluid
- Patterning, or repeating actions to overcome the brain injury
- Adeli suit therapy, which involves wearing clothing with attached resistance bands to improve strength, coordination, and posture
- Feldenkrais, a type of exercise therapy designed to replace inefficient movements with more effective movements via slow, gentle repetitions that are active or passive in nature
- Hyperbaric Oxygen Therapy (HBOT), which exposes the patient to high pressure oxygen in an attempt to treat CP and other cerebral disorders
At this time, limited research has been conducted on these alternative options, with some studies finding conflicting or negative results.
Thus, more research needs to be conducted in this area to better determine whether CAM therapies can provide benefit and, if so, which ones may help the most.
Continued Innovations in CP Treatment Options
There are ongoing advancements in the area of CP treatment. Many have been due to research studies conducted by some of the world’s leading health professionals.
For instance, on October 30, 2017, Duke University published results of a randomized clinical trial involving 63 children with spastic cerebral palsy. The results revealed that children who received cell infusions of their own umbilical cord blood showed improvements in both brain connectivity and motor function. Furthermore, these improvements were greater than those experienced by children given a placebo.
Research has even found that something as simple as playing with the family dog can help. A study released by Oregon State University in May 2017 involved a 10-year-old boy with cerebral palsy. After eight weeks of supervised physical activity with his pet, a 1-year-old Pomeranian, researchers discovered that “the child’s quality of life had increased significantly in several areas, including emotional, social and physical health, as assessed by the child as well as the parent.”
On April 27, 2016, the University of Washington shared that their researchers (in conjunction with Gillette Children’s Specialty Healthcare) created a device that uses EMG (electromyography) data to help doctors better assess whether surgery could provide beneficial results. They call it Walk-DMC and are conducting ongoing research to determine how helpful this device may be.
And in March 2016, researchers from the Technical University of Madrid and Rey Juan Carlos University revealed they created a series of four games played in a virtual environment they’ve called SONRIE. These games can apparently help detect, evaluate, monitor, and rehabilitate the oral-facial musculature of children diagnosed with CP.
Additional CP Treatment Considerations
When choosing the treatment method(s) that may work best for the specific type and severity of CP, other considerations need to be made.
This is especially true if the patient has additional medical conditions to contend with, some of which are relatively common for adults and children with CP, such as:
- Hydrocephalus (cerebrospinal fluid buildup in the skull)
- Gastrointestinal issues (acid reflux)
- Oral issues (overbites, underbites, decay and enamel issues)
- Urological Issues (frequent urinary tract infections, or UTIs)
In these instances, additional treatment methods may be required to effectively manage CP along with the other existing medical conditions.
Pre-Treatment Preparation Suggestions
Regardless of which treatment methods you choose, there are a few things you can do to prepare for your initial visit.
This includes compiling the follow information:
- A list of all symptoms experienced by the patient, and how long they have been experiencing them
- All medications taken regularly by the patient, even vitamins and supplements because some of these may interact with a prescription medication’s absorption and effectiveness
- All results from medical tests previously taken by the patient, and any medical records and/or notes from those doctors and therapists
- A list of all of the questions you would like to have answered
The better prepared you are for the visit, the more capable you are of giving the doctor or therapist the information he or she needs to make a proper diagnosis and provide a solid recommendation for treatment.