Gabapentin as Add-on Therapy to Trihexyphenidyl in Children with Dyskinetic Cerebral Palsy: A Randomized, Controlled...

Area of Science:

• Neurology
• Pediatrics
• Rehabilitation Medicine

Background:

• Dyskinetic cerebral palsy (CP) is a movement disorder characterized by involuntary movements.
• Dystonia is a common symptom in dyskinetic CP, significantly impacting motor function.
• Current treatments aim to manage symptoms and improve quality of life.

Purpose of the Study:

• To evaluate the efficacy of gabapentin as an add-on therapy to trihexyphenidyl for treating dyskinetic cerebral palsy (CP) in children.
• To compare the effects of gabapentin plus trihexyphenidyl versus trihexyphenidyl alone on dystonia severity.

Main Methods:

• An open-labelled, randomized controlled trial involved children aged 3-9 years with severe dyskinetic CP (GMFCS 4-5).
• Participants were randomized into two groups: gabapentin with trihexyphenidyl (n=30) and trihexyphenidyl alone (n=30).
• Dystonia severity was assessed using the Dyskinesia Impairment Scale (DIS), Dystonia Severity Assessment Plan (DSAP), and ICF-CY at baseline, 4, and 12 weeks.

Main Results:

• Both treatment groups showed significant reductions in baseline dystonia.
• However, no significant differences in dystonia severity were observed between the gabapentin add-on group and the trihexyphenidyl-alone group at 4 and 12 weeks.
• Constipation was the most frequent side effect, occurring in 11.5% and 14.3% of participants in the respective groups.

Conclusions:

• Trihexyphenidyl monotherapy is as effective as the combination of gabapentin and trihexyphenidyl in reducing dystonia severity in children with dyskinetic CP at 12 weeks.
• Gabapentin does not provide additional benefit when used as an add-on therapy for dystonia in this population.
• Further research may explore alternative or adjunctive treatments for managing dystonia in pediatric CP.