Cerebral Palsy World
Home Contact Message Board Guestbook Chat Room Our Supporters
What is CP?
Signs & Symptoms
Types of CP
Real-Life Stories
CP & Your Health
Success Stories
History of CP
United Cerebral Palsy
Economic Impact
Independent Living
CP & Law
CP Dictionary
Causes of CP
CP & Education
CP & Celebrities
Ability Camp


Interpersonal Therapy




Are There Treatments for Other Conditions Associated with Cerebral Palsy?


Brand-new treatment for children with cerebral palsy

How To Treat Cerebral Palsy

A Treatment Center

Integral Neurorehab

Cerebral palsy doesn't always cause profound disabilities.   While one child with severe cerebral palsy might be unable to walk and need extensive, lifelong care, another with mild cerebral palsy might be only slightly awkward and require no special assistance. Supportive treatments, medications, and surgery can help many individuals improve their motor skills and ability to communicate with the world.

There is no cure, but various forms of therapy can help a person with the disorder to function and live more effectively. In general, the earlier treatment begins the better chance children have of overcoming developmental disabilities or learning new ways to accomplish the tasks that challenge them. The earliest proven intervention occurs during the infant's recovery in the neonatal intensive care unit (NICU). Treatment may include one or more of the following: physical therapy; occupational therapy; speech therapy; drugs to control seizures, alleviate pain, or relax muscle spasms (e.g. benzodiazepienes, baclofen and intrathecal phenol/baclofen); hyperbaric oxygen; the use of Botox to relax contracting muscles; surgery to correct anatomical abnormalities or release tight muscles; braces and other orthotic devices; rolling walkers; and communication aids such as computers with attached voice synthesizers. For instance, the use of a standing frame can help reduce spasticity and improve range of motion for people with CP who use wheelchairs. Nevertheless, there is only some benefit from therapy. Treatment is usually symptomatic and focuses on helping the person to develop as many motor skills as possible or to learn how to compensate for the lack of them. Non-speaking people with CP are often successful availing themselves of augmentative and alternative communication systems such as Blissymbols.


Interpersonal therapy

Physiotherapy programs are designed to encourage the patient to build a strength base for improved gait and volitional movement, together with stretching programs to limit contractures. Many experts believe that life-long physiotherapy is crucial to maintain muscle tone, bone structure, and prevent dislocation of the joints.

Occupational therapy helps adults and children maximise their function, adapt to their limitations and live as independently as possible

Speech therapy helps control the muscles of the mouth and jaw, and helps improve communication. Just as CP can affect the way a person moves their arms and legs, it can also affect the way they move their mouth, face and head. This can make it hard for the person to breathe; talk clearly; and bite, chew and swallow food. Speech therapy often starts before a child begins school and continues throughout the school years

Conductive education was developed in Hungary from 1945 based on the work of András Pető. It is a unified system of rehabilitation for people with neurological disorders including cerebral palsy, Parkinson's disease and multiple sclerosis, amongst other conditions. It is theorised to improve mobility, self-esteem, stamina and independence as well as daily living skills and social skills. The conductor is the professional who delivers CE in partnership with parents and children. Skills learned during CE should be applied

 to everyday life and can help to develop age-appropriate cognitive, social and emotional skills. It is available at specialized centers.

Biofeedback is an alternative therapy in which people with CP learn how to control their affected muscles. Some people learn ways to reduce muscle tension with this technique. Biofeedback does not help everyone with CP.

Neuro-cognitive therapy It is based upon two proven principles. (1) Neural Plasticity. The brain is capable of altering its own structure and functioning to meet the demands of any particular environment. Consequently if the child is provided with an appropriate neurological environment, he will have the best chance of making progress. (2) Learning can lead to development. As early as the early 1900s, this was being proven by a psychologist named Lev Vygotsky. He proposed that children's learning is a social activity, which is achieved by interaction with more skilled members of society. There are many studies which provide evidence for this claim. There are however, as yet no controlled studies on neuro-cognitive therapy.

alternative therapy  for people with CP. The method is promoted by The Institutes for the Achievement of Human Potential (IAHP), a Philadelphia nonprofit, but has been criticized by the American Academy of Pediatrics.[25] The IAHP's methods have been endorsed by Linus Pauling,[26] as well as some parents of children treated with their methods

Massage therapy[30] is designed to help relax tense muscles, strengthen muscles, and keep joints flexible. More research is needed to determine the health benefits of these therapies for people with CP.

Threshold electrical stimulation, which involves the application of electrical stimulation at an intensity too low to stimulate muscle contraction, is a controversial therapy.  Studies have not been able to demonstrate its effectiveness or any significant improvement with its use.



Orthopedic surgery is often recommended when spasticity and stiffness are severe enough to make walking and moving about difficult or painful.  For many people with cerebral palsy, improving the appearance of how they walk - their gait - is also important.  A more upright gait with smoother transitions and foot placements is the primary goal for many children and young adults.

In the operating room, surgeons can lengthen muscles and tendons that are proportionately too short.  But first, they have to determine the specific muscles responsible for the gait abnormalities.  Finding these muscles can be difficult.  It takes more than 30 major muscles working at the right time using the right amount of force to walk two strides with a normal gait. A problem with any of muscles can cause an abnormal gait. 

In addition, because the body makes natural adjustments to compensate for muscle imbalances, these adjustments could appear to be the problem, instead of a compensation.   In the past, doctors relied on clinical examination, observation of the gait, and the measurement of motion and spasticity to determine the muscles involved.  Now, doctors have a diagnostic technique known as gait analysis.

Gait analysis uses cameras that record how an individual walks, force plates that detect when and where feet touch the ground, a special recording technique that detects muscle activity (known as electromyography), and a computer program that gathers and analyzes the data to identify the problem muscles. Using gait analysis, doctors can precisely locate which muscles would benefit from surgery and how much improvement in gait can be expected.

The timing of orthopedic surgery has also changed in recent years.  Previously, orthopedic surgeons preferred to perform all of the necessary surgeries a child needed at the same time, usually between the ages of 7 and 10.  Because of the length of time spent in recovery, which was generally several months, doing them all at once shortened the amount of time a child spent in bed.  Now most of the surgical procedures can be done on an outpatient basis or with a short inpatient stay.  Children usually return to their normal lifestyle within a week.

Consequently, doctors think it is much better to stagger surgeries and perform them at times appropriate to a child's age and level of motor development.  For example, spasticity in the upper leg muscles (the adductors), which causes a "scissor pattern" walk, is a major obstacle to normal gait.  The optimal age to correct this spasticity with adduction release surgery is 2 to 4 years of age.  On the other hand, the best time to perform surgery to lengthen the hamstrings or Achilles tendon is 7 to 8 years of age.  If adduction release surgery is delayed so that it can be performed at the same time as hamstring lengthening, the child will have learned to compensate for spasticity in the adductors.  By the time the hamstring surgery is performed, the child's abnormal gait pattern could be so ingrained that it might not be easily corrected.      

With shorter recovery times and new, less invasive surgical techniques, doctors can schedule surgeries at times that take advantage of a child's age and developmental abilities for the best possible result.  

Selective dorsal rhizotomy (SDR) is a surgical procedure recommended only for cases of severe spasticity when all of the more conservative treatments - physical therapy, oral medications, and intrathecal baclofen -- have failed to reduce spasticity or chronic pain.  In the procedure, a surgeon locates and selectively severs overactivated nerves at the base of the spinal column.

Because it reduces the amount of stimulation that reaches muscles via the nerves, SDR is most commonly used to relax muscles and decrease chronic pain in one or both of the lower or upper limbs.  It is also sometimes used to correct an overactive bladder.  Potential side effects include sensory loss, numbness, or uncomfortable sensations in limb areas once supplied by the severed nerve.

Even though the use of microsurgery techniques has refined the practice of SDR surgery, there is still controversy about how selective SDR actually is.  Some doctors have concerns since it is invasive and irreversible and may only achieve small improvements in function.  Although recent research has shown that combining SDR with physical therapy reduces spasticity in some children, particularly those with spastic diplegia, whether or not it improves gait or function has still not been proven.  Ongoing research continues to look at this surgery's effectiveness. 

Spinal cord stimulation was developed in the 1980s to treat spinal cord injury and other neurological conditions involving motor neurons.  An implanted electrode selectively stimulates nerves at the base of the spinal cord to inhibit and decrease nerve activity.   The effectiveness of spinal cord stimulation for the treatment of cerebral palsy has yet to be proven in clinical studies.  It is considered a treatment alternative only when other conservative or surgical treatments have been unsuccessful at relaxing muscles or relieving pain.



Cooling high-risk full-term babies shortly after birth may significantly reduce disability or death.[40]

Early nutritional support: In one cohort study of 490 premature infants discharged from the NICU, the rate of growth during hospital stay was related to neurological function at 18 and 22 months of age. The study found a significant decrease in the incidence of cerebral palsy in the group of premature infants with the highest growth velocity. This study suggests that adequate nutrition and growth play a protective role in the development of cerebral palsy.[41]

Hyperbaric oxygen therapy (HBOT), in which pressurized oxygen is inhaled inside a hyperbaric chamber, has been studied under the theory that improving oxygen availability to damaged brain cells can reactivate some of them to function normally. A 2007 systematic review concluded that the effect of HBOT is no different from that of pressurized room air, and that some children undergoing HBOT will experience adverse events such as seizures and the need for ear pressure equalization tubes; due to poor quality of data assessment the review also concluded that estimates of the prevalence of adverse events are uncertain



Oral medications such as diazepam, baclofen, dantrolene sodium, and tizanidine are usually used as the first line of treatment to relax stiff, contracted, or overactive muscles.  These drugs are easy to use, except that dosages high enough to be effective often have side effects, among them drowsiness, upset stomach, high blood pressure, and possible liver damage with long-term use.  Oral medications are most appropriate for children who need only mild reduction in muscle tone or who have widespread spasticity.

Doctors also sometimes use alcohol "washes" -- injections of alcohol into muscles -- to reduce spasticity.   The benefits last from a few months to 2 years or more, but the adverse effects include a significant risk of pain or numbness, and the procedure requires a high degree of skill to target the nerve.

The availability of new and more precise methods to deliver antispasmodic medications is moving treatment for spasticity toward chemodenervation, in which injected drugs are used to target and relax muscles

Botulinum toxin (BT-A), injected locally, has become a standard treatment for overactive muscles in children with spastic movement disorders such as cerebral palsy.  BT-A relaxes contracted muscles by keeping nerve cells from over-activating muscle.  Although BT-A is not approved by the Food and Drug Administration (FDA) for treating cerebral palsy, since the 1990s doctors have been using it off-label to relax spastic muscles.  A number of studies have shown that it reduces spasticity and increases the range of motion of the muscles it targets. The relaxing effect of a BT-A injection lasts approximately 3 months.  Undesirable side effects are mild and short-lived, consisting of pain upon injection and occasionally mild flu-like symptoms.  BT-A injections are most effective when followed by a stretching program including physical therapy and splinting.    BT-A injections work best for children who have some control over their motor movements and have a limited number of muscles to treat, none of which is fixed or rigid.

Because BT-A does not have FDA approval to treat spasticity in children, parents and caregivers should make sure that the doctor giving the injection is trained in the procedure and has experience using it in children

Intrathecal baclofen therapy uses an implantable pump to deliver baclofen, a muscle relaxant, into the fluid surrounding the spinal cord.  Baclofen works by decreasing the excitability of nerve cells in the spinal cord, which then reduces muscle spasticity throughout the body.  Because it is delivered directly into the nervous system, the intrathecal dose of baclofen can be as low as one one-hundredth of the oral dose.  Studies have shown it reduces spasticity and pain and improves sleep.  

The pump is the size of a hockey puck and is implanted in the abdomen.  It contains a refillable reservoir connected to an alarm that beeps when the reservoir is low.  The pump is programmable with an electronic telemetry wand.  The program can be adjusted if muscle tone is worse at certain times of the day or night.   

The baclofen pump carries a small but significant risk of serious complications if it fails or is programmed incorrectly, if the catheter becomes twisted or kinked, or if the insertion site becomes infected.  Undesirable, but infrequent, side effects include overrelaxation of the muscles, sleepiness, headache, nausea, vomiting, dizziness, and constipation.

As a muscle-relaxing therapy, the baclofen pump is most appropriate for individuals with chronic, severe stiffness or uncontrolled muscle movement throughout the body.  Doctors have successfully implanted the pump in children as young as 3 years of age.


Are There Treatments for Other Conditions Associated with Cerebral Palsy?

Epilepsy.  Twenty to 40 percent of children with mental retardation and cerebral palsy also have epilepsy.  Doctors usually prescribe medications to control seizures.  The classic medications for this purpose are phenobarbital, phenytoin, carbamazepine, and valproate.  Although these drugs generally are effective in controlling seizures, their use is hampered by harmful or unpleasant side effects.

Treatment for epilepsy has advanced significantly with the development of new medications that have fewer side effects.  These drugs include felbamate, gabapentin, lamotrigine, levetiracetam, oxcarbazepine, tiagabine, topiramate, vigabatrin, and zonisamide.

In general, drugs are prescribed based on the type of seizures an individual experiences, since no one drug controls all types. Some individuals may need a combination of two or more drugs to achieve good seizure control.

Incontinence.  Medical treatments for incontinence include special exercises, biofeedback, prescription drugs, surgery, or surgically implanted devices to replace or aid muscles. Specially designed absorbent undergarments can also be used to protect against accidental leaks.  

Osteopenia.  Children with cerebral palsy who aren't able to walk risk developing poor bone density (osteopenia), which makes them more likely to break bones.  In a study of older Americans funded by the National Institutes of Health (NIH), a family of drugs called bisphosphonates, which was recently approved by the FDA to treat mineral loss in elderly patients, also appeared to increase bone mineral density.  Doctors may choose to selectively prescribe the drug off-label to children to prevent osteopenia.  

Pain.   Pain can be a problem for people with cerebral palsy due to spastic muscles and the stress and strain on parts of the body that are compensating for muscle abnormalities.  Some individuals may also have frequent and irregular muscle spasms that can't be predicted or medicated in advance.

Doctors often prescribe diazepam to reduce the pain associated with muscle spasms, but it's not known exactly how the drug works to interfere with pain signals.  The drug gabapentin has been used successfully to decrease the severity and frequency of painful spasms.  BT-A injections have also been shown to decrease spasticity and pain, and are commonly given under anesthesia to avoid the pain associated with the injections.  Intrathecal baclofen has shown good results in reducing pain, but its delivery is invasive, time intensive, and expensive.

Some children and adults have been able to decrease pain by using noninvasive and drug-free interventions such as distraction, relaxation training, biofeedback, and therapeutic massage finance researchers




Brand-new treatment for children with cerebral palsy

How to Treat Cerebral Palsy

A Treatment Center

Integral Neurorehab


Disclaimer    |   References and Sources
Website hosted by Computer Development Systems, LLC