Related Experiment Videos
Age-dependent effects of trihexyphenidyl in extrapyramidal cerebral palsy
A H Hoon1, P O Freese, E M Reinhardt
1Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Insights
Trihexyphenidyl (Artane) may improve upper extremity function and expressive language in children with extrapyramidal cerebral palsy. Younger children appear to benefit most from this medication.
Area of Science:
- Neurology
- Pediatrics
- Pharmacology
Background:
- Trihexyphenidyl (Artane) is a muscarinic antagonist used for generalized dystonia.
- Extrapyramidal cerebral palsy (CP) presents challenges in motor function and communication.
- Evaluating trihexyphenidyl's efficacy in pediatric CP is crucial for treatment optimization.
Observation:
- A retrospective survey assessed 22 children with extrapyramidal CP.
- Parental questionnaires evaluated changes in upper/lower extremity function, expressive language, and drooling.
- Improvements were noted in upper extremity function, expressive language, and drooling, but not lower extremity function.
Findings:
- Younger children showed a greater therapeutic response to trihexyphenidyl.
- Significant improvements were observed in fine motor skills and verbal expressive language.
- No significant benefits were found for lower extremity function.
Implications:
- Trihexyphenidyl may be a beneficial treatment option for specific symptoms in pediatric CP.
- Early intervention with trihexyphenidyl could enhance functional outcomes in younger children.
- Further prospective, masked studies are warranted to validate these findings and establish standardized assessment protocols.
Abstract:
Trihexyphenidyl (Artane) is a centrally active muscarinic antagonist commonly used to treat patients with generalized dystonia. In a retrospective survey of 22 consecutive children with extrapyramidal cerebral palsy, we evaluated trihexyphenidyl on upper extremity and lower extremity function, expressive language, and drooling. Functional changes were assessed using a parental questionnaire (rating scale 1-5: from 1 = little or no change to 5 = tremendous change, with scores in either a positive or negative direction). Improvements of +4 or +5 were reported in eight children for upper extremity function, in eight children for verbal expressive language, in five for drooling, and in none for lower extremity function. Using bivariate linear regression modeling to investigate variables associated with treatment effects, there was a significant inverse relationship between age at initiation of medication and therapeutic response. Furthermore, beneficial responses were specific to upper-extremity function and expressive language. These results suggest that younger children are more likely to respond to trihexyphenidyl and that primary functional benefits include improved fine motor abilities and expressive language. A prospective masked study with a standardized clinical instrument is needed to confirm these findings.