Source:Pediatric Neurology
Author(s): Mahesh Kamate, Nishant Mittal, Deepa Metgud
BackgroundTherapeutic options for management of choreoathetoid cerebral palsy which is a permanent disorder are very limited. Available medications either have significant side effects or are unsuitable for long-term use. Risperidone has shown promise in the management of chorea and has been found to be safe in children less than 5 years.MethodsChildren with choreoathetoid cerebral palsy were enrolled after parental consent and given risperidone for 6-months period along with standard care. The choreoathetoid movements were assessed using Abnormal Involuntary Movement Scale, the upper-limb functions were assessed using Quality of upper extremity skill tests and the quality of life using Cerebral palsy-Quality of life. Side effects were monitored clinically, by biochemical tests and electrocardiogram.ResultsOut of 42 children with chorea-athetoid cerebral palsy who were screened over a period of 1-year, 35 subjects meeting the study criteria were enrolled. Thirty children completed 6-months of risperidone therapy, remaining 5 subjects were excluded because of time missed due to intercurrent unrelated illnesses. Data of these 30 children was analysed as per per-protocol analysis. Their mean age was 6.35±3.17 years. Abnormal movements showed statistically significant decline after risperidone (19.7 vs. 14.7, p<0.0001). Functional ability of upper-limbs and quality of life also showed improvement (37.0 vs 43.8, p<0.0001 and 64.3 vs. 70.0, p<0.0001 respectively) after 6-months of risperidone therapy. Positive change in the behaviour was also noted. It was well tolerated without significant side-effects.ConclusionRisperidone is a promising drug to manage children with choreoathetoid cerebral palsy and is well tolerated in children.
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