Insights into Management of Cerebral Palsy

Cerebral palsy (CP) is a neurodevelopmental disorder characterized by abnormalities of muscle tone, movement and motor skills, which babies are born with or that develops very early in life, though some children with cerebral palsy may not have noticeable symptoms until they are toddlers. Babies with cerebral palsy are often slow to roll over, sit, crawl, or walk. Children with cerebral palsy continue to have symptoms for life. But the disorder does not get worse with age. Many children with cerebral palsy also have other problems, including: Trouble drinking or eating leading to not gaining enough weight, choking, acid reflux, Lung infections, trouble thinking and learning, problems with hearing and speaking, trouble seeing, seizures,  a curved spine, problems with bladder control, dislocation of the hip joints and Pain.  Many Investigations may be needed to diagnose, evaluate severity as MRI which is an imaging test that takes pictures of the inside of the brain and An EEG that measures electrical activity in the brain and records brain wave patterns. Management includes early intervention program which have different types of experts who will teach parents how to help child do everyday things they might have trouble doing including eating, speaking, walking, and learning. Treatments include firstly medicines for stiff muscles, unusual body movements, or seizures in addition to Equipment including devices such as leg braces, walkers, or a wheelchair. The patient may need special diets and may need to get some or all of their food through a tube that goes directly into the stomach which called a “gastrostomy tube” or “g-tube Surgery. For children with very severe symptoms, doctors sometimes do surgery to put the child’s legs or arms into a correct position.


Cerebral palsy (CP) is a major cause of motor and mental handicap among children leading to an enormous economic burden.  There are certain neurotropic and neuroprotective medications which can improve gross motor function, spasticity, speech, quality of life in patients with CP.  For example,  an Egyptian boy with perinatal hypoxia and periventricular leukomalacia who had severe motor and mental delay due to preterm delivery who was unable to raise his head,  sit supported with mental delay at the age of one and seven months although seeking medical advice in many specialized neuropediatric medical centers came to my clinic at hospital to whom I have prescribed a combination of neuroprotective medications with concomitant physiotherapy and early rehabilitation program for one year and 4 months and till the age of 2 years and 11 months with significant improvement in behavior, attention, motor function, symbolic, speech and speech composite scores,  reduction of hypertonia and spasticity with no side effects according to  Gross Motor Function Classification System (GMFC), Communication Function Classification System (CFCS), and Modified Ashworth  Scale for spasticity. Family is very happy seeing a handicapped child to walk supported who is waiting only for tendon transfer to walk independently.  Actually, the developing brain has a unique ability to respond to neuroprotective medications in some cases of cerebral palsy which carry hope for reducing effects of injury to brain and which needs extensive work up and research in the future. So, there may be a good chance for every baby who is not supporting head at 4 months age, not sitting unsupported at 10 months, not standing at 14 months, not walking at 1 year associated or not associated with mental or speech delay compared to his or her peers or diagnosed with motor or mental delay due to brain related cause to come with parents to seek medical advice in the proper time to  attain the best possible chances of improvement.










Dr. Aly Ragheb Aly Farrag Elayyat