Treatments
Medications
Physical Therapy
The best results for treating spasticity usually come from using a combination of treatments based on the individual child's needs and goals. We develop a complete plan of care for each patient and offer all of the newest medications and surgical procedures available. These include:
- Physical and occupational therapy can improve muscle tone and function through a variety of stretching, strengthening and adaptive techniques. Proper positioning, orthotic and equipment use at home, school and in the car are essential to reduce abnormal muscle patterns and improve safety.
- Splinting or casting tight muscle areas may reduce energy use, improve mobility and function, and keep muscles stretched during rapid growth periods.
- Oral medications are effective in many patients and are safe to take long term. Because they enter the bloodstream, they affect all the muscles of the body. In some patients with a mixture of weakness as well as spasticity, the medicines may have to be given in lower doses. Sedation can be an initial side effect, but this generally improves. Baclofen, Dantrium® and Zanaflex® are commonly used oral medicines.
- Injectable medications such as Botox®, Myobloc® and Phenol can reduce tone in specific muscles. Their effect typically lasts for several months. During this time, tight areas are stretched and weak muscles strengthened. Injections often are repeated when growth causes contractures or when there is a specific therapy goal.
- Orthopedic procedures can correct misaligned bones and improve restricted joint motion. Mobility, brace wear and pain control all can improve if surgery is done at the correct time. Treating the spasticity that has pulled the bones into improper position is important prior to and after surgery.
- Selective dorsal rhizotomy involves surgically cutting the spinal rootlets, permanently altering the messages that lead to spasticity in the legs. Only certain children are good candidates for this procedure and intensive physical therapy follow-up is needed.
- Intrathecal baclofen (ITB) can be useful when long-term tone reduction is needed. ITB treatment delivers medication from an implanted pump, directly to the spinal nerves that are causing the spasticity. This does not cause the sedation side effect that oral medication can and provides very specific muscle relaxation. Spasticity in both the upper and lower extremities can improve and can be given based on the individual patient's needs.
|
