title: Bedtime diazepam enhances well-being in children with spastic cerebral palsy.
abstract: In work with children with cerebral palsy at Ashirvad, Child Development and Research Centre, Chennai, India, the authors were confronted with fretful children who resisted any attempt to mobilize their limbs due to hypertonia and muscle spasm. It was found that administering a bedtime dose of diazepam to reduce hypertonia and muscle spasm alongside passive stretching exercises significantly improved the behaviour of the child. There was significant improvement in the well-being of the child during the activities of daily living and this reduced the family's burden of caring for the child. In this double blind, placebo-controlled, randomized clinical trial, each child received a bedtime dose of diazepam or placebo. The bedtime diazepam relaxed the muscles and this made the passive stretching easy and the movements sustained the muscle relaxation during the day. There were fewer unwarranted crying spells during the day and less wakefulness during the night. The adverse effect of day time sedation was not observed with the use of a single dose of diazepam at bedtime.
authors.affiliation: Continuing Medical Education Department, Christian Medical College, Vellore, T.Nadu, India. ashirvad@cmcvellore.ac.in
authors.forename: Anna
authors.initials: A
authors.lastname: Mathew
authors.forename: M C
authors.initials: MC
authors.lastname: Mathew
mesh_terms: D000203:Activities of Daily Living; D002547:Cerebral Palsy / Q000534:rehabilitation*; D002648:Child; D003975:Diazepam / Q000627:therapeutic use*; D005081:Exercise Therapy; D006801:Humans; D009125:Muscle Relaxants, Central / Q000627:therapeutic use*; D009128:Muscle Spasticity / Q000534:rehabilitation
chemical_list: D009125:Muscle Relaxants, Central; D003975:Diazepam