From the Guidelines
COPASTIN is not recommended for an 11-year-old child as there is no evidence to support its use in pediatric patients, and the provided guideline evidence focuses on adult stroke rehabilitation care. The management of spasticity in children requires a different approach, and the use of medications such as tizanidine, baclofen, dantrolene, and diazepam should be carefully considered based on the individual child's needs and medical history 1. In pediatric patients, the treatment of spasticity typically involves a multidisciplinary approach, including physical therapy, occupational therapy, and orthotics, with medication used as an adjunct to these therapies.
- The goal of treatment is to improve mobility, prevent contractures, and enhance quality of life.
- Medications such as botulinum toxin, baclofen, and tizanidine may be considered in certain cases, but their use should be guided by a pediatric specialist with expertise in spasticity management.
- The provided guideline evidence does not support the use of COPASTIN in pediatric patients, and its safety and efficacy in this population have not been established 1.
- Therefore, alternative treatment options should be explored, and the child's care should be managed by a multidisciplinary team of healthcare professionals with expertise in pediatric rehabilitation and spasticity management.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Treatment Options for Spasticity in Children
- There are several treatment options available for managing spasticity in children, including oral medications, injection therapy, and intrathecal baclofen therapy (ITB) 2, 3.
- ITB is a valuable alternative for children with intractable spasticity, as it is effective, nondestructive, titratable, and reversible 2.
- The treatment options for spasticity can be subdivided into pharmacologic and surgical approaches, with pharmacologic options including medications taken by mouth, given through an injection (Botox) or delivered by a pump (baclofen) 4.
Efficacy and Safety of Baclofen
- Baclofen has been shown to be effective in reducing spasticity in children with cerebral palsy, with improvements in range of motion, upper extremity function, and activities of daily living 2, 3.
- However, baclofen can cause adverse effects, such as asthenia, drowsiness, and sleepiness, particularly when used in combination with physical therapy 5.
- The efficacy and safety of baclofen compared to other medications, such as tolperisone, have been studied, with results suggesting that baclofen may be more effective but also more likely to cause adverse effects 5.
Neurosurgical Treatments for Spasticity and Movement Disorders
- Neurosurgical treatments, such as peripheral neurotomies, selective lumbar rhizotomies, and intrathecal baclofen infusions, have been developed for children with spasticity and movement disorders associated with cerebral palsy 6.
- These treatments can effectively alleviate spasticity and improve movement disorders, although the effectiveness of different treatments can vary depending on the specific condition and individual child 6.