Pharmacologic management of the spastic and dystonic upper limb in children with cerebral palsy.
Spasticity or dystonia of the upper limb in children with CP commonly is seen as part of a more involved clinical picture. Each can cause functional problems in and can interfere with the quality of life of children with CP. Pharmacologic manipulation of the spasticity and dystonia requires a patient and ordered approach. Treatment often is performed using an open trial method, with medications introduced slowly but often being limited in their usefulness by significant side effects. Despite multiple medications being available for spasticity and dystonia management, few of the oral treatments have been assessed systematically in children with CP. Specific evaluation of the use of enteral medications in upper limb management is even rarer.
Department of Rehabilitation, Children's Hospital at Westmead, Locked Bag 4001, Westmead, Sydney NSW 2145, Australia. stepheno@chw.edu.au
Stephen
S
O'Flaherty
Mary-Clare
MC
Waugh
D001132:Arm / Q000503:physiopathology*; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use; D002547:Cerebral Palsy / Q000188:drug therapy* / Q000503:physiopathology; D002648:Child; D018680:Cholinergic Antagonists / Q000627:therapeutic use; D015259:Dopamine Agents / Q000627:therapeutic use; D004421:Dystonia / Q000188:drug therapy* / Q000503:physiopathology; D018757:GABA Modulators / Q000627:therapeutic use; D006801:Humans; D009465:Neuromuscular Agents / Q000627:therapeutic use
D018680:Cholinergic Antagonists; D015259:Dopamine Agents; D018757:GABA Modulators; D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A