Article

AIM: To evaluate the actual evidence of efficacy of oral pharmacological
treatments in the management of dyskinetic cerebral palsy (CP). METHOD: A systematic review was performed according to the American Academy for Cerebral
Palsy and Developmental Medicine (AACPDM) and Preferred Reporting Items for
Systematic Reviews and Meta-Analyses methodology. Articles were searched for in
PubMed/MEDLINE, Scopus, Web of Science, Cochrane Library, Database of Reviews of
Effectiveness, OTSeeker, Physiotherapy Evidence Database, REHABDATA, and
ClinicalTrials.gov. RESULTS: Sixteen articles met the eligibility criteria. Eight
studies on trihexyphenidyl and two on levodopa showed contradictory results. Low
efficacy was reported for diazepam, dantrolene sodium, perphenazine, and
etybenzatropine. Tetrabenazine, gabapentin and levetiracetam should be studied in
more detail. The updated available evidence does not support any therapeutic
algorithm for the management of dyskinetic CP. INTERPRETATION: This lack of
evidence is partially owing to the inconsistency of classifications of patients
and of outcome measures used in the reviewed studies. Further randomized,
double-blind, placebo-controlled pharmacological trials, optimized for different
age groups, based on valid, reliable, and disease-specific rating scales are
strongly needed. Outcome measures should be selected within the framework of the
International Classification of Functioning, Disability and Health. WHAT THIS
PAPER ADDS: Evidence to prove (or disprove) the efficacy of oral drugs in
dyskinetic cerebral palsy is low. The most investigated drugs, trihexyphenidyl
and levodopa, show contradictory results. Tetrabenazine, levetiracetam, and
gabapentin efficacy should be studied in more detail. Lack of evidence is
partially due to the inconsistency of classifications and outcome measures used.
Outcome measures should be selected within the framework of the International
Classification of Functioning, Disability and Health in next clinical trials.
CI - (c) 2017 Mac Keith Press.

Langue : ANGLAIS