There is no cure for cerebral palsy but there are a range of treatments that can help to maximise the child's abilities and make the symptoms easier to manage.
Physiotherapy
Physiotherapy usually starts soon after a diagnosis is made and is used to help with movement and posture. The goal of physiotherapy is to stop muscular problems from getting worse.
Medication
Botulinum toxin is injected into muscles making them less stiff and enabling joints to mover more freely. The side effects of the injections are said to be mild and short-lived. The most common are:
Baclofen is injected (via a pump that is implanted under the skin of the abdomen) directly into the fluid that surrounds the spinal cord and thus reduces muscle hyperactivity. Side-effects can include loose muscles, drowsiness, nausea, headache and dixxiness. These are usually temporary and can be managed by adjusting the dose delivered by the pump.
The pump needs to be refilled every two months, this is done by inserting a needle through the skin and into the pump.
According to SCOPE, pumps need to be replaced every five or six years. Children as young as five have been fitted with the pump but this does depend on the size of the abdominal cavity.
Surgery
Surgery is sometimes required to loosen muscles that have permanently tightened around joints to form contractures which immobilises the limb.
A surgical procedure known as selective dorsal rhizotomy(SDR) is used to reduce spasticity in the lower limbs. In this procedure three to five nerve rootlets in the lower spine are cut. The NICE recommendations instruct doctors to inform patients and/or their carers or parents that the procedure is irrevesible, that there is a risk of serious complications and that there will be extensive physiotherapy and rehabilitation required after the the procedure.
The NICE guidance notes that "patients who were previously able to walk may have to learn to walk again" after the operation.
SCOPE says this about SDR- "Selective Dorsal Rhizotomy is in some ways a controversial intervention, which has not yet been subjected to adequate controlled trials. As with all surgical intervention the potential gains must be weighed against the possible sensory loss, the trauma of intervention and the need for lengthy and intensive post-operative therapy. Decrease in muscle tone has been consistently reported in treatment carried out to date – reports are mixed regarding the long-term effects on function. Full evidence of side-effects is not yet available."
Braces and supports
Children may be fitted with braces casts or splints. The types of suppport to be used will depend on a child's individual needs. For example, a child may be fitted with a cast to restrict movement in one area and to strengthen muscles and tendons in another part of the body.
Other treatements that may be required include:
