Oral Medication Use in Cerebral Palsy
摘要
The treatment of generalised hypertonia in cerebral palsy (CP) with the use of oral medications can be challenging in terms of improvement in patient function and quality of life. Despite the duration of published experience in the use of oral medications in CP, evidence for effect is generally limited. Spasticity, which is characterised by a velocity-dependent increase in muscle tone, can be treated with medications including baclofen and diazepam with complementary effects at the GABA spinal receptor level. Gabapentin also has a GABA agonistic effect and has gained use in the treatment of both spasticity and dystonia. Experience in the treatment of dyskinetic CP, which includes dystonia, chorea and athetosis, has largely focused on dystonia management. Anticholinergic medications including trihexyphenidyl have shown promise with evidence for improvement in upper limb function. Levodopa is commonly used for dystonia despite a lack of evidence for effect. Effective treatment of chorea and athetosis in CP remains elusive. The chapter is in all fields up to this day revised.