Effect of Magnesium Therapy on Spasticity and Constipation in Children with Cerebral Palsy

Abstract

Cerebral palsy (CP) is the most common chronic disability of childhood today. It is ubiquitous and it occurs all around the world. In developed nations, the incidence is about 1 to 2 per 1000 births. Spasticity is a hallmark of neurological diseases that affect the central nervous system. It can cause discomfort and stiffness, while spasms can be annoying and painful and may interfere with function. Constipation is common. In such children, constipation is generally believed to be the result of both neurological and lifestyle factors. The aim of the current study was to determine the effect of oral magnesium sulfate on muscle spasticity and on constipation in children with cerebral palsy. This prospective study was conducted in the period from March 2014 to May 2015. Participants were randomly recruited after fulfilling the inclusion criteria from the Pediatrics Neurology Clinic, Children's hospital, Faculty of Medicine, Ain Shams University after obtaining a written consent from their care givers. It Included 30 children with spastic CP. They were 21 males and 9 females there were 25 quadriplegic and 5 diplegic spastic CP. they were on oral magnesium sulfate on 10 mg/kg/day as a single dose for 1 month. Summary 92 All children were subjected to the following before and after intervention: (a) Muscle tone evaluation by Modified Ashworth Index (MAS). (b) Ankle joint dorsiflexion range of motion (ROM) by hand-held goniometer. (c) Evaluation of soleus muscle H-reflex amplitude. (d) Constipation was defined according to criteria in children with neurological disabilities. In the present study, CP children showed statistically significant reduction in spasticity and improvement in motor function and constipation after the 30 of therapy with oral magnesium sulfate. Results of the current study showed highly significant improvement after therapy in the following spasticity assessment tools: Modified Ashworth scale (MAS), Ankle joint dorsiflexion range of motion (ROM) by hand held goniometer, M-reflex and H-reflex while no statistical difference in H/M ratio. Our study showed that children with cerebral palsy had increase in the frequency of bowel movements per week with a highly statistically significant difference before and after treatment with oral magnesium sulfate. There was no occurrence of diarrhea.