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Does Spastic Cerebral Palsy Respond To Levodopa?

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Posted on Wed, 3 Jun 2015
Question: My son is 38 years old and was dx with spastic cp a a a baby. His mri of the brain did not show any damage. Since then his condition has gotten worse and he has a lot of pain. After seeing a show where a woman had been incorrectly dx with cp got better with sinamet we decided to try giving him an herbal extract that gives him some levadopa. He has had a response. Pain is gone and movement is easier and he is having a lot less trouble swallowing and sitting up. My question is does spastic cp respond to levadopa or are we looking at dopamine responsive dystonia.
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Answered by Dr. Ajay Panwar (1 hour later)
Brief Answer:
Spastic CP does not respond to Levodopa.

Detailed Answer:
Hi XXXX,
Thanks for being on healthcaremagic.com.
I am Dr.Ajay Panwar,a neurologist,here to answer your query.

I am pleased to have read such an interesting and a classical history.Surely,Cerebral palsy(CP) has been often confused with Dopa responsive dystonia(DRD) and it is well reported in medical literature.

There are a few strong points which negates CP as a diagnosis here-
1)MRI being normal is against CP.
2)Progressive nature of the disease is against CP,in which case it would have been on a static course.
3)In CP,symptoms do not respond to Levodopa.

DRD typically responds to low dose Levodopa.It has a progressive course and MRI is usually normal in DRD.So,in a way,all these points are in agreement with the diagnosis of DRD.It is a well documented fact that DRD is a strong differential in a case of atypical CP.So,he can very well be having DRD only.

Other classical and hallmark point to note for DRD is diurnal fluctuation.Symptoms worsen towards evening and night and are almost normal in the morning.So,please note for this fluctuation,If it is present,it almost confirms the diagnosis of DRD.
Anyway,treatment with Levodopa has to be continued,as the response is good.Working diagnosis should be kept as DRD.He should be examined by a neurologist to document the effects of Levodopa,like reduced spasticity after Levodopa dose.

Hope that I have answered your query.If you have some follow up questions,I shall be glad to answer else please close the thread,rate it and write a review as your rating will be of help to me.

Regards
Dr.Ajay Panwar,
MD,DM(Neurology)
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Ajay Panwar

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Practicing since :2007

Answered : 1827 Questions

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Does Spastic Cerebral Palsy Respond To Levodopa?

Brief Answer: Spastic CP does not respond to Levodopa. Detailed Answer: Hi XXXX, Thanks for being on healthcaremagic.com. I am Dr.Ajay Panwar,a neurologist,here to answer your query. I am pleased to have read such an interesting and a classical history.Surely,Cerebral palsy(CP) has been often confused with Dopa responsive dystonia(DRD) and it is well reported in medical literature. There are a few strong points which negates CP as a diagnosis here- 1)MRI being normal is against CP. 2)Progressive nature of the disease is against CP,in which case it would have been on a static course. 3)In CP,symptoms do not respond to Levodopa. DRD typically responds to low dose Levodopa.It has a progressive course and MRI is usually normal in DRD.So,in a way,all these points are in agreement with the diagnosis of DRD.It is a well documented fact that DRD is a strong differential in a case of atypical CP.So,he can very well be having DRD only. Other classical and hallmark point to note for DRD is diurnal fluctuation.Symptoms worsen towards evening and night and are almost normal in the morning.So,please note for this fluctuation,If it is present,it almost confirms the diagnosis of DRD. Anyway,treatment with Levodopa has to be continued,as the response is good.Working diagnosis should be kept as DRD.He should be examined by a neurologist to document the effects of Levodopa,like reduced spasticity after Levodopa dose. Hope that I have answered your query.If you have some follow up questions,I shall be glad to answer else please close the thread,rate it and write a review as your rating will be of help to me. Regards Dr.Ajay Panwar, MD,DM(Neurology)