By Andrea Watson, Texas Tech Zinc Link
Children with cerebral palsy and their families face challenges every day,
from dealing with tight, spastic muscles or seizures, to the social stigma
sometimes associated with the condition. However, through a discovery made
by a Texas Tech University Health Sciences Center physician, one of those
struggles may be lessened.
Daniel Hurst, M.D., a child neurologist at the Health Sciences Center, believes the use of a prescription medication for narcolepsy may be able to treat muscle spasticity in children with cerebral palsy. He has treated a small number of patients with the medication, modafinil, and has seen remarkable improvement in their muscles, he said.
Hurst said the initial discovery came about largely by accident. The initial patient who showed improvement on the drug was originally brought in for treatment of seizures and attention deficit disorder.
“Modafinil can be effective for ADD, but without the side effects of the traditional medications,” he said. “So we started him on the medication to see if we could improve the ADD. The child had been taking the modafinil for a couple of weeks when he had an appointment to see an orthopaedic surgeon for a consultation before a surgical procedure on his ankles because he was walking on his toes. I received a call from the surgeon saying the procedure had been canceled because the child’s muscle spasticity had improved so much he didn’t need the surgery.”
Hurst admits he was surprised about the improvement in the patient’s condition, but there was no other reason for the change in the muscle condition other than the medication.
To verify the effectiveness of the modafinil on muscle spasticity, researchers in the Department of Neurology completed a pilot study in late 2001.
“We did the pilot study with 10 patients. We involved a physical therapist to evaluate the children’s muscle stiffness. Each child was evaluated before they began taking the medication and after they had been on the medication for a month,” he said. “Most children showed improvement in their muscles and in the speed at which they could walk. They also showed improvement in the distance they were able to walk.”
Because using modafinil to treat muscle spasticity is a unique usage for the drug, the Health Sciences Center is considering the possibility of seeking a patent for the new use. The pilot study also has been published in the Journal of Child Neurology.
Hurst said another, larger study has been developed to further research the effectiveness of the modafinil.
“We’re fairly certain this study will prove the effectiveness of the drug one way or the other,” he said.
Hurst acknowledges that seeing these kinds of results from a drug that was developed to treat narcolepsy is unusual, but based on how the drug works within the brain, he is not especially surprised.
“Modafinil’s action for treating narcolepsy is thought to be direct stimulation of certain brain stem centers,” he said. “The areas of the brain stem stimulated by the drug are right next to the motor centers of the brain stem. One of those areas is related to muscle spasticity. We think direct stimulation of the brain stem is important because it’s regulating those areas and telling them not to make the muscles as stiff.”
He further said that stimulation of the lower centers of the brain stem as a treatment for narcolepsy is well understood, leading to the theory that the drug works in a similar fashion for treating the spasticity.
Overall, Hurst said, the most important part of this discovery is the possibility of improving the treatment options for patients with cerebral palsy.
“This could mean less surgery for these patients and less sedating
effects than traditional treatments,” he said. “From my standpoint,
this medication has tremendous potential. This drug has the definite potential
to improve the quality of life for many cerebral palsy patients.”