Dyskinesia

Dystonia is underdiagnosed in children with cerebral palsy, and there is little evidence to support interventions. Management can be complex and allied health and rehabilitation physician review is advised. Oral baclofen, trihexyphenidyl (benzhexol) and gabapentin may be used in generalised dystonia. Intrathecal baclofen or deep brain stimulation may be used when severe generalised dystonia impacts significantly on care, comfort and quality of life. Targeted botulinum toxin injections may be used for the management of focal dystonias.

There is a lack of evidence for the management of athetosis. The mainstay of treatment of athetosis is physiotherapy. Medications are generally less useful for athetosis than for dystonias, but atypical neuroleptics (eg risperidone, quetiapine), or dopamine-depleting agents (eg reserpine, tetrabenazine) are sometimes used—seek specialist advice (eg from a rehabilitation physician).