Spasticity of muscles, along with the limitations on stretching and use of muscles in daily activities, is a major cause of deformities. Oral medications, such as valium and baclofen, are still tried, but the consensus is that they do not reduce spasticity. Injections of Botox into muscles have been used widely in recent years. Botox weakens muscles for up to 3-4 months after injection, reducing spasticity in a limited group of muscles. Most important, the effect is only temporary.
Side effects appear to be minimal.
Baclofen infusion, using a pump implanted in the abdominal wall, is clearly effective in reducing spasticity in spinal cord injury and can also reduce CP spasticity. Also, the baclofen infusion carries risks of overdose, meningitis, and other complications that may require repeated hospitalization, and since it has been used for CP for only several years, long-term consequences are not known. Orthopaedic surgery certainly improves range of motion of the joints and makes it easier for children to move the lower extremities. A major side effect is permanent muscle weakness and resulting abnormal postures and deformities. Also, orthopaedic surgery does not reduce spasticity directly but treats only the consequences of spasticity.