Effect of Risperidone on the Motor and Functional Disability in Children With Choreoathetoid Cerebral Palsy

Therapeutic options for management of choreoathetoid cerebral palsy, which is a permanent disorder, are 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 five years.

Children with choreoathetoid cerebral palsy were enrolled after parental consent and given risperidone for six-month 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.

Of 42 children with choreoathetoid cerebral palsy who were screened over a period of one year, 35 subjects meeting the study criteria were enrolled. Thirty children completed six months of risperidone therapy, the remaining five subjects were excluded because of time missed due to intercurrent unrelated illnesses. Data of these 30 children were analyzed 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 six months of risperidone therapy. Positive change in the behavior was also noted. It was well tolerated without significant side effects.

Risperidone is a promising drug to manage children with choreoathetoid cerebral palsy and is well tolerated in children.