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Treatment of spasticity in children with low dose benzodiazepine
M Dahlin1, E Knutsson, A Nergårdh
1Department of Pediatrics, Karolinska Hospital, Stockholm, Sweden.
Insights
Low-dose clonazepam effectively reduced spasticity in children with cerebral palsy. This study found a significant decrease in spastic restraint after a single dose, suggesting a potential therapeutic benefit.
Area of Science:
- Neurology
- Pediatrics
- Pharmacology
Background:
- Cerebral palsy is a common condition characterized by spasticity.
- Benzodiazepines are often used to manage spasticity, but optimal dosing in children requires investigation.
Purpose of the Study:
- To evaluate the efficacy of low-dose clonazepam in reducing spasticity in children with cerebral palsy.
- To compare the effects of clonazepam with a placebo in a controlled study.
Main Methods:
- A double-blind, placebo-controlled, cross-over study was conducted.
- Twelve children with spastic diplegia or hemiplegia participated.
- Spasticity was measured using a dynamic dynamometer and EMG activity before and after intramuscular injections of clonazepam or placebo.
Main Results:
- Clonazepam significantly reduced spastic restraint (P < 0.001).
- Placebo showed a non-significant reduction in spasticity.
- Mean plasma concentration of clonazepam was low (21 mmol/l), below conventional doses.
Conclusions:
- Low-dose clonazepam demonstrates a positive effect in reducing spasticity in children with cerebral palsy.
- A single dose of low-dose clonazepam can be effective in managing spasticity.
Abstract:
In an attempt to investigate whether benzodiazepines at low dosage have a significant effect in reducing spasticity among children with cerebral palsy, we carried out a double-blind, placebo-controlled, cross-over study. Twelve children with either spastic diplegia or hemiplegia participated in this study. The mean age was 14 years. The restraint of passive knee movements was determined with a dynamic dynamometer and spastic stretch reflexes were measured as EMG activity in muscles stretched. Clonazepam was given at low dosage (0.02 mg/kg body weight). In each child measurements of passive restraint were made on 2 different days immediately before and 3 h after an i.m. injection of either clonazepam or placebo in randomized order. Clonazepam significantly reduced spastic restraint (P < 0.001) compared to non-significant reduction with placebo. The mean plasma concentration of clonazepam at time of spasticity evaluation was 21 mmol/l which is in the low dose range, far below conventional doses. The study thus shows a positive effect of low dose clonazepam in reducing spasticity in children when given as a single dose.