There is no effective etiologic treatment yet, and current treatment focuses on taking appropriate measures to help obtain maximum functional improvement.
I. Physical therapy and rehabilitation training.
1. perfect care, good hygiene and adequate nutrition
2, long-term adherence to scientific language, functional and skill training;
3, the use of physical therapy, body therapy and combined with massage to promote muscle relaxation, improve the motor function of the lower limbs, gait and posture.
4, braces and orthotics can help control purposeless movements, improve posture and prevent deformities;
5.Operational therapy for the fingers facilitates movement training for feeding, dressing, writing and other movements related to self-care.
Second, drug treatment
The current drug efficacy is still unstable, the effect is more limited, and the side effects are also larger;
1, chlorambucil: spasticity history can be applied, adverse effects include drowsiness, nausea, vertigo, respiratory depression, and occasionally urinary retention;
2, Antan (with central anticholinergic effect) and clonidine are suitable for spastic type;
3. Benadryl may be tried in tremors.
4. Haloperidol, Valium and sodium valproate can be tried in case of excessive movement;
5.Anti-epileptic drugs should be given to those with epilepsy;
6, the treatment of nuclear jaundice: the birth of jaundice is a serious case, should be exchanged for blood transfusion, can reduce the level of bilirubin, to protect the nervous system; or give serum albumin, to promote bilirubin binding; or ultraviolet radiation, to promote the conversion of indirect bilirubin and other methods.
Third, surgical treatment
SPR is a combination of modern fiber surgery techniques and electrophysiological techniques to selectively cut a portion of the Ia-like muscle spindle afferent fibers in the posterior root of the spinal nerve that are related to the muscle tension reflex. It is important to reduce the peripheral excitatory afferents in the γ-loop that regulates muscle tone and postural reflexes, and to correct the spasticity of the limb caused by impaired downward inhibition due to cortical lesions; the ability to walk before surgery, near-normal intelligence and adherence to postoperative systematic rehabilitation are the basic conditions for successful treatment.
2.Partial stripping of the outer membrane of bilateral common carotid arteries: By stripping part of the outer membrane of common carotid arteries, the sympathetic nerve network is cut off, vascular tone is reduced, cerebral blood supply is increased, and brain cell development is promoted; at the same time, the patient’s tension can be reduced, so it is suitable for patients with hand-foot tardive and mixed cerebral palsy.
3. Partial narrowing of peripheral nerves: for some patients with increased muscle tone in a single muscle group, this procedure can be adopted to narrow the nerves innervating the muscle group and reduce the peripheral excitatory afferents. It is suitable for patients with simple clubfoot, forearm rotation dysfunction, and elbow extension dysfunction.
4.Stereotactic cerebral pallidum destruction: It is effective for some patients with tardive dyskinesia and cerebral palsy with extrapyramidal impairment such as torsional spasm, but it is easy to recur and may bring about new neurological deficits. This procedure is not suitable for spastic cerebral palsy, and blind expansion of its indications is strictly prohibited.
5.Orthopedic surgery series: For some patients with severe deformities, orthopedic surgery can be performed to restore normal form, restore muscle balance, loosen spastic soft tissues and stabilize joints.
4.Neural stem cell transplantation is still in the research stage, and the efficacy is uncertain.