Cerebral Palsy – OrthoInfo – AAOS

Individuals who have cerebral palsy often need help from their families and medical specialists throughout their lives. Many types of healthcare professionals are involved in treating those with CP. Depending upon the type of CP your child has, as well as any additional impairments, the medical treatment team may include:

Physical therapy. Physical therapy may be recommended shortly after the diagnosis is made in order to help your child learn skills such as sitting, walking, or using a wheelchair. It also may help improve muscle strength, balance, and coordination, as well as prevent muscles from becoming too tight. Physical therapy may involve fun activities to tone muscles, like swimming and horseback riding.

Braces, splints, and casts. Using braces, splints, or casts may improve range of motion in joints and joint stability, prevent contracture, and improve hand or leg function. Braces can compensate for muscle imbalance.

Botox. This drug can be injected into spastic muscles to loosen them. It is especially helpful for children younger than 5 years old, and when used in combination with casting.

Medication. Some medications (such as oral diazepam and baclofen) can control or prevent seizures or muscle spasms, ease muscle stiffness, or reduce abnormal movements.

If contractures are severe, surgery to lengthen affected muscles can improve a child's ability to move and walk. This surgery may also help if tightly contracted muscles cause stress to joints and lead to deformities or dislocations.

Some children with CP need surgery to correctly position their arms or legs, or to correct curvature of the spine (scoliosis).

Severe spasticity and muscle stiffness may be helped with an intrathecal baclofen pump. In this procedure, a small pump is surgically implanted under the skin to deliver doses of a muscle relaxant.

If other treatments cannot effectively manage severe spasticity, your doctor may recommend selective dorsal rhizotomy. During this surgery of the spine, specific nerves that control spastic muscles are cut to help the muscles relax, as well as to relieve associated pain. This particular type of surgery is done infrequently.

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Cerebral Palsy - OrthoInfo - AAOS