Cerebral Palsy: Treatments and Therapeutics

Abstract

Cerebral palsy (CP) is a non‐progressive motor disorder affecting approximately 3 out of every 1000 infants in the United States. Although it is classified as a motor disorder, the deficits are caused by pre‐ or neonatal brain injury. Unfortunately, there is no cure for CP and currently, symptom management is the only treatment option available. As research begins to unravel the underlying causes and cellular changes leading to CP, potential treatments and therapeutics can be investigated to prevent brain damage following insults. Today, only two therapies are approved for use in the hospital setting: hypothermia and magnesium sulphate. Both of these therapies attempt to lessen the brain damage by slowing processes of inflammation and cell death. Other potential therapies are in clinical trials to test safety and efficacy for use in humans. Some drugs have shown promise in animal models; however, they have not yet been tested in humans. Researchers are searching for a cure.

Key Concepts

  • There is no cure for cerebral palsy and currently approved treatments target the symptoms of cerebral palsy, not the underlying causes.
  • Hypothermia and magnesium sulphate are the only two therapeutics used in the hospital setting to slow or lessen brain damage following labour and delivery complications.
  • Therapeutics targeting the excitatory amino acid neurotransmitter glutamate, along with glutamate receptor and transporter expression and function, appear to be promising.
  • Drug treatments targeting growth factors and endogenous proteins may be beneficial to reduce cell death leading to cerebral palsy.
  • Because inflammation plays a role in cerebral palsy, drug treatment that reduces the inflammatory response may also reduce brain damage following insults.

Keywords: cerebral palsy; drug therapy; growth factors; glutamate; glutamate receptors; glutamate transporters; inflammation

Figure 1. Treatments and therapeutics for acquired cerebral palsy. There are many different causes of acquired cerebral palsy and many potential treatments. Blue squares with black arrows represent potential causes leading to cerebral palsy (red box). The green boxes with red arrows indicate potential therapeutic interventions at each stage.
Figure 2. Treatments and therapeutics for congenital cerebral palsy. The underlying causes of congenital cerebral palsy are not known, but based upon the type of injury seen in cerebral palsy patients, infections and hypoxia‐ischemia are thought to account for the majority of congenital CP cases. Blue squares with black arrows represent potential causes leading to cerebral palsy (red box). The green boxes with red arrows indicate potential therapeutic interventions at each stage.
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Further Reading

Beloosesky R (2011) Magnesium sulfate may offer protection from cerebral palsy. Neurology Reviews 19: 13.

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Gunn AJ, Williams CE, Bennet L, Cook CJ and Gluckman PD (1988) Perinatal cerebral asphyxia: pharmacological intervention. Fetal Therapy 3: 98–107.

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Feather‐Schussler, Danielle N, and Ferguson, Tanya S(Feb 2015) Cerebral Palsy: Treatments and Therapeutics. In: eLS. John Wiley & Sons Ltd, Chichester. http://www.els.net [doi: 10.1002/9780470015902.a0026121]