Medicine To Treat Paediatric Complex Motor Disorders

This article talks about medicine to treat paediatric complex motor disorders.

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What is t​his medicine used for​

MedicineHow does the medici​ne work?
​​Antispasmodics
e.g. baclofen
Helps muscles to relax. This will help your child to move, and make it easier and less painful to move them. It may also help to reduce muscle pain.​
​Anticholinergics
e.g. Benzhexol



​In children with dystonia, the muscles have contracted too much and are too tight so that the head, arms or legs are held in awkward or uncomfortable positions. Benzhexol blocks the effects of a chemical messenger called acetylcholine that is released from the nerves to make the muscle contract. It helps the muscles to relax. This should allow a better range of movement in the affected part of the body and reduce painful spasms.
​Benzodiazepines,
e.g. diazepam, nitrazepam, clonazepam
​Helps to reduce symptoms of spasticity, and other movement disorders such as dystonia, and myoclonus. It modifies the chemical transmission in the brain. It helps your child’s muscles to relax. This should also help to reduce muscle pain.
​Chloral Hydrate


​Helps to reduce symptoms of dystonia by modifying the chemical transmission in the brain. It is also used in children with sleep-onset disorder (difficulty getting to sleep), muscle spasm/ dystonia and agitation.
​Clonidine


​Helps to reduce symptoms of dystonia by modifying the chemical transmission in the brain. It is also used in children with Tourette’s syndrome, attention-deficit hyperactivity disorder (ADHD) and sleep-onset disorder (difficulty getting to sleep).
​Gabapentin

​Helps to reduce symptoms of dystonia by modifying the chemical transmission in the brain. It also helps to reduce muscle pain and neuropathic pain (nerve pain).
​Levodopa
e.g. Madopar

​Levodopa is absorbed by the brain cells and turned into the chemical dopamine, which is used to transmit messages between the parts of the brain and nerves that control movement. Increasing the levels of dopamine helps to improve movement problems.​

​​

Dosage and Ho​​w to use

Your doctor will instruct you on how much and how often your child should take the medicine. Do not take more of the medicine or take it more often than what the doctor tells your child to. Most medicine can be taken with or without food. Give the medicine at the same time each day.

The medicine starts to work straight away. However, because the dose is usually increased gradually, it may take some weeks before the full effect can be seen.

Do not stop taking the medicine without checking with the doctor first.

Missed a D​​​ose

If your child miss a dose, give it as soon as you remember. However, if it is almost time for the next dose, skip the missed dose and continue with the regular dosing schedule. Do not double the dose to make up for the missed dose.​


Side Effects, Precautions, Contraindication​​

What are the possible side effects of the ​​medicine?

We use medicines to make our children better, but sometimes they have other effects that we don’t want (side-effects).​

Medicine​

​​Attend hospital straight away if your child has any of these side effects:​ If your child has problems with these less serious side effects, talk with your doctor/ pharmacist:
Antispasmodics
e.g. baclofen


















  • ​​Seizure (also called a fit or convulsion)
  • excessive sleepiness or difficult to wake up
  • breathing difficulty












  • drowsy (sleepy), dizzy
  • confusion
  • trouble sleeping or nightmares
  • constipation
  • nausea (feeling sick)
  • difficulty with passing urine
  • If your child’s muscles become too floppy (hypotonic)
  • emotional, anxious or overactive or may have problems with their memory​



​Anticholinergics
e.g. benzhexol








​​

  • ​excessive sleepiness or difficult to wake up
  • difficulty with passing urine, or unable to pass urine





  • drowsy (sleepy), dizzy
  • blurred vision
  • constipation, nausea, vomiting
  • dry mouth
  • emotional, anxious or overactive or may have problems with their memory.

​Benzodiazepaines,
e.g. diazepam, nitrazepam, clonazepam​












  • ​excessive sleepiness or difficult to wake up
  • breathing difficulty
  • skin rash
  • yellowing of skin or eyes
  • hallucinations



  • drowsy (sleepy), dizzy
  • If your child becomes too floppy
  • difficulty controlling their movements (ataxia) or walking
  • difficulty talking
  • salivary drooling
  • emotional, anxious or overactive or may have problems with their memory
​Chloral Hydrate





  • ​excessive sleepiness or difficult to wake up
  • breathing difficulty


  • ​drowsy (sleep), dizzy
  • nausea, vomiting
  • stomach upset/ heartburn
​Clonidine











  • ​​excessive sleepiness or difficult to wake up









  • ​drowsy (sleepy) or dizzy
  • dry mouth
  • constipation
  • nausea, vomiting
  • headaches
  • agitated or restlessness at night
​Gabapentin














  • ​excessive sleepiness or difficult to wake up












  • ​drowsy (sleepy), dizzy
  • unsteadiness
  • changes in appetite
  • nausea, vomiting
  • diarrhoea/ constipation, wind, indigestion
  • dry mouth
  • emotional, anxious or overactive or may have problems with their memory​
​Levodopa
e.g. Madopar










    excessive sleepiness​










  • ​​drowsy (sleepy), dizzy
  • ​nausea or vomiting
  • stomach upset
  • ​​dry mouth
  • ​emotional, anxious or overactive or may have problems with their memory
  • chorea (abnormal involuntary movements)​
There may, sometimes, be other side-effects that are not listed above. If you notice anything unusual and are concerned, please contact your doctor or pharmacist.

​​​


Version 1
Last Review: 16/2/2017
Produced by Dr Yeo Tong Hong (Neurology Services) and Department of Pharmacy
KK Women’s and Children’s Hospital

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Medicine To Treat Paediatric Complex Motor Disorders

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