A new evidence-based clinical guideline published by the American Academy of Neurology in the January 26, 2010, edition of the journal Neurology® makes recommendations for the pharmacological treatment of spasticity in children and adolescents with cerebral palsy (CP). The guideline finds botulinum toxin type A to be an effective treatment for spasticity, muscle tightness that interferes with movement, in children and adolescents with CP, but poses some risk.
For generalized spasticity that warrants treatment, the guideline recommends that diazepam be considered for short-term treatment. Tizanidine also may be considered. However, there are insufficient data to support or refute use of dantrolene, oral baclofen, or continuous intrathecal baclofen (ITB). Neurologists need to know the benefits and risks of any medications their referred patients have been taking for spasticity. The minimal evidence for commonly used treatments (e.g., oral baclofen and ITB) presents an opportunity for encouraging new research.