The medical management of cerebral palsy

Medical management of cerebral palsy is a complex issue that should be undertaken with the overall aim to improve comfort, function in every day life, self confidence, participation and independence.Although the main focus is commonly the motor disorder, medical management also encompasses far wider issues including the management of multiple co-morbidities (e.g. epilepsy, visual and hearing impairment, gastro-oesophageal reflux and constipation, learning and behavioural difficulties) which require close multi-disciplinary teamwork.High muscle tone can be broadly considered as either spasticity, dystonia, or commonly a mixed pattern. Strategies to reduce muscle tone include enteral medication, botulinum neurotoxin, intra-thecal Baclofen, and selective dorsal rhizotomy. However, strength training and reduction of inserted involuntary movements are equally important strategies to improve function.We also discuss treatable conditions which mimic cerebral palsy, and explore potential future therapies such as stem cells.