Is treatment with growth hormone effective in children with cerebral palsy?

Abstract

Children with cerebral palsy (CP) often have poor linear growth during childhood, resulting in a diminished final adult height. Here we report a female with CP and short stature but without growth hormone (GH) deficiency who exhibited increased growth during treatment with GH. We also report two other children with CP who were treated with GH: one female with a history of leukemia, and a male with Klinefelter syndrome. These two children were both found to be GH-deficient by insulin provocative GH testing and responded to treatment with increased growth rate. Growth improved to a greater extent in the two children with apparent GH deficiency. In summary, it is felt that GH therapy might be beneficial for children with CP and warrants further investigation.

Cerebral Palsy and Growth Failure at 6 to 7 Years

“…9,10 Decreased growth velocity in children with CP may be related to decreased oromotor coordination with suboptimal nutritional intake secondary to impaired chewing and swallowing, recurrent aspiration, chronic reflux, inadequate provision of required nutritional intake, increased caloric expenditure due to the excessive muscle contraction in spasticity for children with ambulatory CP, and the possibility of growth hormone deficiency. [10][11][12][13][14][15][16][17][18] In addition, comorbidities of CP, including gastroesophageal reflux and aspiration, are associated with slow growth and increased risk of rehospitalization. [19][20][21][22][23] Vigilance regarding growth of children with feeding difficulties goes beyond the concern of body size alone.…”

Growth patterns in a population of children and adolescents with cerebral palsy

“…Endocrine function may also be impaired in patients with brain injuries involving the pituitary gland, and the question of whether growth hormone treatment may be beneficial to some patients with CP has been considered. 16 Although plotting growth of children with CP on standard Centers for Disease Control and Prevention (CDC) charts 1 often reveals significant departures from population norms, it is often unclear whether the departure is typical for children with CP. That is, although a child with quadriplegic CP may fall below the 10th centile on the CDC charts, that patient may be at or above the 50th centile for children with CP and comparable neuromotor dysfunction.…”

Growth hormone/insulin-like growth factor-1 axis: a possible non-nutritional factor for growth retardation in children with cerebral palsy

“…Mais ainda, a terapia de GH levou a um aumento no crescimento de uma menina de baixa estatura com PC, mesmo sem deficiência documentada de GH; sendo assim, o tratamento com GH pode ser benéfico para crianças portadoras de PC 6 .…”

“…O eixo GH não foi sistematicamente analisado em crianças com PC, e o número de estudos relatando se a PC compromete ou não a secreção de GH é bastante limitado 5,6 . No entanto, foram relatadas alterações na secreção de GH nessas crianças 7 .…”