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Cerebral Palsy: Treatment, Procedure, Cost and Side Effects

Last Updated: May 20, 2024

What is the treatment?

Cerebral palsy is a condition that mostly affects children. This is generally a disorder of movement, posture or muscle tone and it is the result of some damage to the immature, developing brain. It mostly affects a child even before its birth. Children generally experience the symptoms during the preschool years or infancy. A child may suffer from impaired movement which is associated with abnormal reflexes, abnormal posture, involuntary movement, unsteady walking, rigidity or floppiness of the trunk and limbs or a combination of all these symptoms. People suffering from this condition may also have problems with swallowing and even experience vision problems due to imbalance of the eye muscle. Cerebral palsy may cause a person to lose mobility while it may result in intellectual disability in some other person. Some of the other symptoms may include blindness, deafness and epilepsy.

Cerebral palsy may be caused due to a number of factors. So the treatment for cerebral palsy is also as complex as the disease itself. The main target of treating cerebral palsy includes: improving mobility, controlling pain, managing the primary conditions, maximizing independence, fostering self-care, improving interactions with the society and family, improving the potential to learn, controlling the pain and furnishing a better quality of life.

Treatment involves taking a lot of different steps. A child may require the services of an entire medical care team which can include a pediatrician, orthopaedic surgeon, speech-language specialist, mental health specialist, developmental therapist, physical therapist and even a special education teacher. Sometimes medications and alternative therapies are also used. In some cases, a physician my also recommend surgery.

How is the treatment done?

Both children and adults afflicted with cerebral palsy require the services of a medical care team which includes a pediatrician or physiatrist who oversees the entire treatment plan. An orthopedic surgeon is required to treat the muscle and bone disorders. A child suffering from this condition may require the services of an occupational therapist, who will help him/her to develop the skills and to learn to use adaptive products that will help him/her in performing daily activities. A speech-language specialist helps a person to deal with problems with speech, language and swallowing problems. A special education teacher will help a person to address the problems associated with learning by identifying the special educational requirements of the person.

Sometimes a doctor may recommend medications to improve the functioning of the body, to treat pain or to manage any complications that may arise related to spasticity or other symptoms of cerebral palsy. Doctors may recommend Botox injections to be administered directly into the muscle or nerve if a person suffers from spasticity of a single muscle group. Drugs like Valium, dantrium and gablofen are oral muscle relaxants that are used to treat generalized spasticity.

Physical therapy, occupational therapy, recreational therapy and speech and language therapy help a person with cerebral palsy to improve his/her functional abilities. Furthermore, orthopedic surgery may be recommended to children suffering from severe contractures or deformities. This surgery is basically used to place arms, legs or hips in their correct positions. When all other treatments have failed, a surgeon may perform a procedure called selective dorsal rhizotomy. This involves cutting the nerves that serves the spastic muscle.

Who is eligible for the treatment? (When is the treatment done?)

A person suffering from cerebral palsy may suffer from underdeveloped or overdeveloped muscles, poor balance and coordination known as ataxia, spastic paralysis, athetosis or involuntary and slow writhing movements and limited range of body movement. The child may have problems with his/her basic development; have problems with vision or hearing, may suffer from seizures, may drool and have problems with sucking, swallowing and feeding and also have difficulty in controlling bladder or bowel movements. A person experiencing some or most of these symptoms is eligible for treatment.

Who is not eligible for the treatment?

A physician may check an infant’s medical history and track his/her development to see whether he/she is suffering from cerebral palsy or not. A doctor will examine a child’s movements, posture, muscle tone and also his/her reflexes. A child not diagnosed by a doctor to be suffering from this condition is not eligible for treatment. A person may suffer from other conditions which have similar symptoms like tumor or muscular dystrophy. In such cases blood tests, head ultrasound or an MRI or CT scan may be performed for proper diagnosis.

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Are there any side effects?

Botox injections may cause side effects like allergic reactions, itching, rash, stiffness of muscles, shortness of breath, nausea, pain in the neck and back, muscle weakness, diarrhea, stomach pain and difficulty in swallowing. A person may also suffer from injection site reactions like bruising, bleeding, redness, swelling and infection. A person taking diazepam may suffer from shakiness, unsteadiness and even may experience problems with controlling or coordinating muscle. Patients may also suffer from post-surgical complications if he/she has undergone orthopedic surgery or selective posterior rhizotomy.

What are the post-treatment guidelines?

A child’s functional abilities are impaired if he/she suffers from cerebral palsy. The best treatment includes nondrug therapies like physical therapy, occupational therapy, recreational therapy and speech and language therapy. There is basically no cure for cerebral palsy. A person suffering from this will have some impairment and the most that can be done is manage the symptoms and ease the pain. So a person will have to undertake treatment for a long time. Hence, there are no such post-treatment guidelines.

How long does it take to recover?

There is no such treatment for cerebral palsy. The brain injury or the problem causing cerebral palsy does not get worse, but in some other cases, newer complications may arise. People with cerebral palsy are often considered healthy even if they have impairment. A child affected by this condition my live for 30-70 years depending on the severity of the condition.

What is the price of the treatment in India?

Botox injections may cost between Rs 15000 – Rs 18000 in India. A speech and language therapy session may cost anything between Rs 6000 and Rs 10000. Physical therapy sessions cost around Rs 3000. Selective dorsal rhizotomy is expensive and may cost more than Rs 20 lakhs.

Are the results of the treatment permanent?

People with cerebral palsy suffer from some impairment. Drugs or different therapies may help them to lead a better life. But they do not normally provide a permanent cure. They help to contain the symptoms. Newer complications may arise as the child gradually ages. Thus, he/she will have to continue with the therapy or continue taking the prescribed drugs. Thus, in most cases, the results are not permanent.

What are the alternatives to the treatment?

Controlled clinical trials like hyperbaric oxygen therapy, resistance exercise training by using special clothing and even some types of electrical stimulation are used to treat cerebral palsy in spite of inconclusive treatment. Doctors are also exploring the reliability of stem cell therapy to treat cerebral palsy.

References

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Written ByDr. Rohit Chakor Fellowship in Joint Replacement & Arthroscopy,Fellowship in Knee and Hip Replacement,MBBS,Fellowship in Trauma and Arthroplasty,Fellowship in Minimally Invasive Joint Replacement Surgery,DNB (Orthopedics),DNB - Orthopedics/Orthopedic SurgeryOrthopaedics
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