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Walking with modafinil and its use in diplegic cerebral palsy: retrospective review
Daniel L Hurst1, Walter A Lajara-Nanson, Margie E Lance-Fish
1Department of Neuropsychiatry, Texas Tech University Health Sciences Center, Lubbock, TX, 79430, USA. daniel.hurst@ttuhsc.edu
Insights
Modafinil treatment showed significant gait improvements in pediatric patients with spastic cerebral palsy. Six patients achieved unassisted ambulation, demonstrating the drug
Area of Science:
- Neurology
- Pediatrics
- Pharmacology
Background:
- Spastic cerebral palsy (CP) is a common childhood motor disorder.
- Impaired gait and ambulation are significant challenges for children with CP.
- Limited pharmacological interventions exist to improve motor function in CP.
Purpose of the Study:
- To evaluate the effect of modafinil on gait and ambulation in pediatric patients with spastic cerebral palsy.
- To assess the potential of modafinil as an adjunctive therapy for improving motor function in CP.
Main Methods:
- Retrospective review of 120 pediatric patients diagnosed with spastic cerebral palsy.
- Analysis of gait improvement in 59 patients treated with modafinil.
- Comparison of outcomes between modafinil-treated and non-treated groups.
Main Results:
- Twenty-nine of 59 modafinil-treated patients showed improved gait.
- Six patients transitioned from assisted or no ambulation to unassisted walking.
- Dramatic gait improvements were observed in some patients with spastic diplegia.
Conclusions:
- Modafinil appears to positively impact tone and ambulation in spastic diplegic cerebral palsy.
- Further research is warranted to explore modafinil's therapeutic potential in CP.
- Modafinil may offer a novel approach to enhancing mobility in pediatric CP patients.
Abstract:
A retrospective review of pediatric patients with spastic cerebral palsy was undertaken at Texas Tech University Health Sciences Center covering a period from January 1, 2000, until December 31, 2003. One hundred twenty pediatric patients were identified in the Texas Tech University Health Sciences Center child neurology clinic with spastic cerebral palsy. Fifty-nine patients of this group received modafinil treatment for cerebral palsy. Twenty-nine of the 59 patients were noted to have an improving gait on modafinil. Six of these modafinil-treated patients improved from no ambulation or only assisted ambulation to unassisted ambulation. This varied from taking a few steps without holding on to walking down the hall without assistance. Two patients with spastic diplegia secondary to prematurity have had a dramatic improvement in gait during the first 6 months after starting modafinil. Two other patients with spastic diplegia not included in this group of six patients taught themselves to stand up and walk while in water unassisted. During this same time period, only three non-modafinil-treated patients with mild cerebral palsy were noted with gait improvements, but not to the dramatic extent of the modafinil-treated group. A nonambulatory 5-year-old child, who presented for a requested wheelchair prescription because the mother had given up all hope of her child ever walking, is now taking independent steps unassisted after starting modafinil. Modafinil, a central nervous system stimulant, appears to improve tone and ambulation in spastic diplegic cerebral palsy.
