Although some children with cerebral palsy are able to reduce muscle tone with oral medications, more often the clinical use of these medications is limited by severe side effects. The most common side effect is excessive sedation, followed by muscle weakness and hypotonia. Baclofen ・Baclofen (Lioresal )
Binding to the inhibitory neurotransmitter gamma-aminobutyric acid (GABA) leads to excessive depolarization. Side effects include excessive sedation, confusion, loss of consciousness, dizziness, decreased muscle strength, ataxia, and inability to concentrate. Rebound may occur with discontinuation of the drug and increased muscle tone. Baclofen is suitable for children who are too young for other more effective methods of treatment. Benzodiazepine ・Benzodiazepine is used to bind GABA at the spinal cord and neurons above the spinal cord. Side effects include drowsiness and drooling, and drug resistance may occur. Short-term use of this drug after surgery can help relieve muscle spasms. Tretinoin – Tretinoin acts directly on skeletal muscle to block the release of calcium ions from the sarcoplasmic reticulum, which in turn weakens or prevents muscle cells from responding to stimulus signals. Side effects include muscle weakness and hepatotoxic reactions. Tizanidine (Zanaflex) acts at the central α2 adrenergic receptor (spinal cord and above) sites to block the release of excitatory neurotransmitters (glutamine and aspartate). Side effects include drowsiness, dizziness and hallucinations, and other possible reactions are hypertension and hepatotoxicity. Although the drug has been shown to be effective in the treatment of multiple sclerosis and spasticity due to spinal cord injury, there are few reports in the literature on the use of the drug in the treatment of cerebral palsy.