Cerebral Palsy Treatments

Although the brain injury that causes cerebral palsy cannot be healed, the resulting physical impairment can be managed with a wide range of treatments. Each child’s impairment is unique and therefore no universal treatment for cerebral palsy exists. Instead, individuals with cerebral palsy are independently assessed and treated for their unique needs.

While therapy and adaptive equipment are the primary treatment for cerebral palsy, a child may also require drug therapy and surgical interventions. Some families, with caution and physician guidance, turn to complementary and alternative medicine for additional assistance.

Although each medical specialist may have specific care goals related to their specialty, the overriding treatment goal for those with cerebral palsy is to:

  • Optimize mobility
  • Manage primary conditions
  • Control pain
  • Prevent and manage complications, associative conditions and co-mitigating factors
  • Maximize independence
  • Enhance social and peer interactions
  • Foster self-care
  • Maximize ability to communicate

NEUROSURGERY

Even though cerebral palsy is a neurological condition, there is no neurosurgery that can cure the condition. There are, however, a variety of neurosurgical interventions that may assist in the management of cerebral palsy. Controversy exists over whether the measures have been proven clinically successful, and experts typically suggest other alternative measures be considered and exhausted before considering a neurosurgical approach. Two common surgeries include:

SELECTIVE DORSAL RHIZOTOMY – Is a surgery done on the lower spinal cord to reduce spasticity or high muscle tone in the legs.  Certain fibers that lead to high muscle tone are cut.

The goal of a selective dorsal rhizotomy is to relax the muscles by identifying and cutting those nerve fibers that are causing the abnormal tone. This can improve your child’s ability to move as well as their quality of movement.  After careful screening, our team of doctors, surgeons and rehabilitation therapists will determine if this procedure is appropriate for your child. Input from you and your child’s community therapist is an essential part of the evaluation process.

Selective dorsal rhizotomy is a surgery done on the lower spinal cord to reduce spasticity or high muscle tone in the legs. Certain nerve fibers that lead to high muscle tone are cut.

The goal of a selective dorsal rhizotomy is to relax the muscles by identifying and cutting those nerve fibers that are causing the abnormal tone. This can improve your child’s ability to move as well as their quality of movement.

After careful screening, our team of doctors, surgeons and rehabilitation therapists will determine if this procedure is appropriate for your child. Input from you and your child’s community therapist is an essential part of the evaluation process.

Visit the St. Louis, Children's Hospital for additional information

 

BACLOFEN PUMP - In this procedure, neurosurgeons place (implant) a pump about the size of a hockey puck in your child's belly (abdomen). The pump continuously delivers a medicine called baclofen into the fluid surrounding your child's spine. Baclofen is a muscle relaxant that reduces spasticity throughout your child's body. Since the medicine goes directly into your child's nervous system, the dose of baclofen your child gets through the pump can be much lower than doses delivered through the mouth. This helps your child avoid the side effects of higher doses (sedation).

If you and your child's neurosurgeon agree that your child can benefit from a baclofen pump, the neurosurgeon does surgery to put the pump under the skin of your child’s belly. Once the pump is in place, the neurosurgeon attaches a thin tube (catheter) to it. Then the neurosurgeon threads the catheter under the skin at waist level to your child's spine. They insert the catheter into the spinal canal.

The baclofen pump must be filled with medicine every one to six months, depending on your child’s dose. You can refill it at Seattle Children’s or at another medical facility. It's important not to let the pump run out of medicine. This could harm your child.

Visit the Center For Cerebral Palsy At UCLA for additional information

VISION SURGERY

Some common vision challenges in individuals with cerebral palsy, include:

Hemianopia – loss of half the visual field (either right or left) often due to damage to the primary visual cortex
In some cases, eyeglasses or contacts will suffice. Surgery may be considered when corrective lenses are not effective.

GASTROENTEROLOGY SURGERY

One way to initiate swallowing is through sucking food through the mouth. The second is by collecting the food on the tongue, then moving the food to the back of the throat to initiate swallowing. This may be difficult to some children with cerebral palsy, particularly when they have impairment to the facial muscles that control these movements.

When the food travels down the throat, the larynx – which is responsible for allowing air into the lungs – closes to allow liquids and solids to travel through the esophagus into the stomach. A child with cerebral palsy can aspirate when their larynx does not close properly. This can lead to food and germs entering the lungs, making the lungs susceptible to infection.

Children with cerebral palsy are at higher risk of bowel and bladder motility problems. Sometimes a change in diet, more frequent intake of fluids and fibers, or suppository assistance may address the concerns.

Gastroenterology surgery is primarily performed to improve sucking, chewing, swallowing, digestion, and food processing. Some common surgical interventions considered for these situations, include:

Gastrostomy tube – this tube is inserted through the abdominal wall to the stomach allowing for uninterrupted oral feeding while supplementing nutrients.
Submandibular duct relocation – this surgical procedure addresses drooling once other measures such as adaptive devices, medications, and therapy are exhausted and proven ineffective.