Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan.
J Formos Med Assoc. 2011 Apr;110(4):215-22. doi: 10.1016/S0929-6646(11)60033-8.
Spasticity is a common disability in children with cerebral palsy. Pharmacological and non-pharmacological treatments, including physical therapy, occupational therapy, orthotics, rhizotomy, and orthopedic surgery, all play important roles in the management of spasticity. The purpose of this article is to provide an overview of available medications for treatment of spasticity in children with cerebral palsy. Common medications include benzodiazepines, dantrolene sodium, baclofen, tizanidine, botulinum toxins, phenol, alcohol and intrathecal baclofen. In general, oral medications and intrathecal baclofen are used for treating generalized spasticity, whilst chemodenervation agents (botulinum toxins, phenol, and alcohol) are used to treat localized spasticity. There is more sufficient evidence for the recommendation of botulinum toxin A as an effective anti-spasticity treatment in children with cerebral palsy. However, more data concerning safety and long-term effects of botulinum toxin A is needed. Further study is needed to determine which kinds of medications can cause substantial improvement in daily activity, participation level, self-competence, or quality of life in children with cerebral palsy.
痉挛是脑瘫儿童常见的残疾。药物和非药物治疗，包括物理治疗、职业治疗、矫形器、脊神经根切断术和矫形手术，在痉挛的治疗中都起着重要作用。本文旨在综述治疗脑瘫儿童痉挛的现有药物。常用药物包括苯二氮䓬类、丹曲林钠、巴氯芬、替扎尼定、肉毒毒素、苯酚、酒精和鞘内巴氯芬。一般来说，口服药物和鞘内巴氯芬用于治疗全身性痉挛，而化学去神经药物（肉毒毒素、苯酚和酒精）用于治疗局部性痉挛。肉毒毒素 A 作为脑瘫儿童有效的抗痉挛治疗药物，其推荐证据更为充分。然而，肉毒毒素 A 的安全性和长期效果的数据仍需要进一步研究。还需要进一步研究来确定哪种药物可以显著改善脑瘫儿童的日常活动、参与水平、自我能力或生活质量。
