Drug InfoNet Doctors' Answers to Frequently Asked Questions

Doctors' Answers to "Frequently Asked Questions" - Cerebral Palsy

These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.

[posted 01/17/2000]
Question: My son is 18, epileptic, petit mal seizures that are under control with phenabarbital and has Hepititas B and cerebral palsy. I know that Baclofen is metabolized in the Kidneys, but am wondering about the effects if any on his liver. The Baclofen has been recommended for spasticity due to Cerebral Palsy and a belief it may stop his back pain because of scoleosis. His back pain is a nagging mild chronic pain. My understanding is that with Hepatitas B
he needs to be on as few medications as possible. I would like some advice on whether to give the Baclofen and possibly stop the back pain and possibly aggravate the Hepatitis B or let him continue with this pain as to not aggravate the Hepatitis B. Please help me weigh the risks.

Answer: I'd try the Baclofen in low doses-advancing if it helps at all. Also, check his liver every 3 months or so and if the liver tests start to rise, stop the medication. You should be able to head off any liver toxicity by close monitoring of his liver function.

Rheumatoid Arthritis with Cerebral Palsy
Question: I am a 41-year-old female with severe quadriplegic cerebral palsy. The spasticity is being treated with Xanax, as Dantrium caused immediate and severe hepatitis. Two years ago, I was also diagnosed with rheumatoid arthritis. NSAIDs and Prednisone alone were ineffective, so disease-modifying agents were added. I first tried Cuprimine, which helped for a time, then stopped helping. I then tried one of the anti-malarial drugs, which did not help and caused disturbances in my vision. For the past year, I have been taking oral Methotrexate (2.5 mg 3 times a week), Deltasone (5 mg daily), and NSAIDs like Relafen and Daypro. The rheumatoid arthritis is progressing, both in severity and in the number of joints affected. I'm having increased difficulty even transferring to and from my wheelchair. I'm also having increasing problems with pain and fatigue.

Answer: Actually, the sequence of drugs is the usual one we try with Rheumatoid Arthritis. Other than advance the dosage of methotrexate you face increasingly more toxic drugs. Some people have tried Cytoxan or Immuran-- both initially anti-cancer drugs like methotrexate. You might want to get a second opinion from a national level figure. Your rheumatologist can arrange this consultation.

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