A Controlled Trial of Baclofen in Children with Cerebral Palsy

Milla, P J; Jackson, A D

doi:10.1177/030006057300100203

Cited by 50 publications

(43 citation statements)

References 6 publications

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“…A double-blind crossover trial in 20 children 2-16 years old receiving a dose of 10 -60 mg/day found a reduction in spasticity by means of the AS (p Ͻ 0.001). 7 After 28 days of treatment, 14 patients improved at least 1 level and 5 improved more than 1 level. Only 2 patients improved while taking placebo.…”

Section: E1mentioning

confidence: 93%

“…6 Alleviation of spasticity may not always be desirable; some patients may experience a decline in function with spasticity reduction. 7 The decision to use antispasticity medications requires careful assessment of the patient's other impairments (e.g., weakness, movement disorders) and proper selection and use of the treatment. Reasons to treat spasticity include reducing pain and muscle spasms, facilitating brace use, improving posture, minimizing contractures and deformity, facilitating mobility and dexterity, and improving patient ease of care as well as hygiene/self-care.…”

mentioning

confidence: 99%

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Practice Parameter: Pharmacologic treatment of spasticity in children and adolescents with cerebral palsy (an evidence-based review)

Delgado¹,

Hirtz²,

Aisen³

et al. 2010

Neurology

259

135

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Objective: To evaluate published evidence of efficacy and safety of pharmacologic treatments for childhood spasticity due to cerebral palsy. Results: For localized/segmental spasticity, botulinum toxin type A is established as an effective treatment to reduce spasticity in the upper and lower extremities. There is conflicting evidence regarding functional improvement. Botulinum toxin type A was found to be generally safe in children with cerebral palsy; however, the Food and Drug Administration is presently investigating isolated cases of generalized weakness resulting in poor outcomes. No studies that met criteria are available on the use of phenol, alcohol, or botulinum toxin type B injections. For generalized spasticity, diazepam is probably effective in reducing spasticity, but there are insufficient data on its effect on motor function and its side-effect profile. Tizanidine is possibly effective, but there are insufficient data on its effect on function and its side-effect profile. There were insufficient data on the use of dantrolene, oral baclofen, and intrathecal baclofen, and toxicity was frequently reported. Methods:

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Section: E1mentioning

confidence: 93%

mentioning

confidence: 99%

Practice Parameter: Pharmacologic treatment of spasticity in children and adolescents with cerebral palsy (an evidence-based review)

Delgado¹,

Hirtz²,

Aisen³

et al. 2010

Neurology

259

135

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show abstract

“…23,24 Baclofen and benzodiazepines act centrally on synaptic neurotransmission, and dantrolene directly affects muscle contractility and has proven useful in treating the spasticity of cerebral palsy. 25 Hepatoxicity is a serious issue with long-term use of dantrolene in 1% of cases, and adverse effects include excessive weakness and gastrointestinal distress.…”

Section: Ongoing Care In the Medical Homementioning

confidence: 99%

Providing a Primary Care Medical Home for Children and Youth With Cerebral Palsy

Cooley¹

2004

Pediatrics

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ABSTRACT. Children and youth with cerebral palsy present pediatricians with complex diagnostic and therapeutic challenges. In most instances, care also requires communication and comanagement with pediatric subspecialists and pediatric surgical specialists, therapists, and community developmental and educational teams. The importance of family resilience to the patient's wellbeing broadens the ecologic scope of care, which highlights the value of a primary care medical home from which care is initiated, coordinated, and monitored and with which families can form a reliable alliance for information, support, and advocacy from the time of diagnosis through the transition to adulthood. This report reviews the aspects of care specific to cerebral palsy that a medical home should provide beyond the routine health maintenance, preventive care, and anticipatory guidance needed by all children. Pediatrics 2004;114:1106-1113; cerebral palsy, developmental disability, medical home, chronic illness, spasticity.

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“…São utilizadas doses progressivas, de até 80-120 mg ao dia, podendo chegar a160 mg ao dia.. Os efeitos colaterais são sonolência, tontura, mal-estar, ataxia, confusão mental, cefaléia, depressão respiratória e cardiovascular e alucinações. 3,15,23 Os benzodiazepínicos atuam nos receptores GABA pré e pós-sinápticos (aumentando a afinidade dos receptores GABA por GABA endógeno), aumentando a inibição sináptica ao nível espinhal e supra-espinhal. Utilizam-se o diazepam e clonazepam.…”

Section: Tratamentounclassified

“…Os efeitos colaterais são muito semelhantes aos do baclofen, principalmente a sedação, sonolência, astenia e agitação paradoxal. 3,15,23 O dantrolene sódico é medicamento de ação periférica, em nível muscular, através do bloqueio da liberação de cálcio no retículo sarcoplasmático, com subseqüente inibição da despolarização. As doses preconizadas estão entre 50 a 800 mg ao dia.…”

Section: Tratamentounclassified

Paralisia cerebral Aspectos Fisioterapêuticos e Clínicos

Leite

Prado²

2019

Rev Neurocienc

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IntroduçãoLittle, em 1843, descreveu, pela primeira vez, a encefalopatia crônica da infância, e a definiu como patologia ligada a diferentes causas e características, principalmente por rigidez muscular. Em 1862, estabeleceu a relação entre esse quadro e o parto anormal. Freud, em1897, sugeriu a expressão paralisia cerebral, que, mais tarde, foi consagrada por Phelps, ao se referir a um grupo de crianças que apresentavam transtornos motores mais ou menos severos devido à lesão do sistema nervoso central, semelhantes ou não aos transtornos motores da Síndrome de Little. 19,20 Designa um grupo de afecções do SNC da infância que não têm caráter progressivo e que apresenta clinicamente distúrbios da motricidade, isto é, alterações do movimento, da postura, do equilíbrio, da coordenação com presença variável de movimentos involuntários. Paralisia cerebral Aspectos Fisioterapêuticos e ClínicosJaqueline Maria Resende Silveira Leite 1 , Gilmar Fernandes do Prado 2 RESUMO A paralisia cerebral congrega um grupo de afecções permanentes do sistema nervoso central sem caráter progressivo e de instalação no período neonatal. Há várias abordagens terapêuticas com possíveis benefícios ao paciente com paralisia cerebral, porém poucas embasadas em evidências científicas indiscutíveis.A abordagem fisioterapêutica teria a finalidade de preparar a criança para uma função, manter ou aprimorar as já existentes, atuando sempre de forma a adequar a espasticidade. Entretanto, o prognóstico da paralisia cerebral depende evidentemente do grau de dificuldade motora, da intensidade de retrações e deformidades esqueléticas e da disponibilidade e qualidade da reabilitação.Este artigo revisa aspectos clínicos da paralisia cerebral, discutindo a fisioterapia e as diversas abordagens terapêuticas utilizadas.Descritores: Paralisia Cerebral, Espasticidade, Tratamento, Reabilitação. SUMMARYCerebral palsy complies a group o permanent and no progressive central nervous system affection installed at neonatal and/or pre natal period. There are many ways to care and possible benefits to cerebral palsy patients, but we have almost no evidence-based approach to treat those patients.Physical therapy could help the child preparing, keeping, or even improving functions, always targeting reduction of spasticity. Of course the cerebral palsy prognostic depends upon the degree of motor impairment, retractions, skeletal deformities, and availability and quality of rehabilitation service.This paper intends to revise some clinical aspects of cerebral palsy, discussing the physical therapy and others therapeutics approaches performed.

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A Controlled Trial of Baclofen in Children with Cerebral Palsy

Cited by 50 publications

References 6 publications

Practice Parameter: Pharmacologic treatment of spasticity in children and adolescents with cerebral palsy (an evidence-based review)

Practice Parameter: Pharmacologic treatment of spasticity in children and adolescents with cerebral palsy (an evidence-based review)

Providing a Primary Care Medical Home for Children and Youth With Cerebral Palsy

Paralisia cerebral Aspectos Fisioterapêuticos e Clínicos

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