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Can Cannabis Help Cerebral Palsy?

by Sarah Pritzker

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Overview 

There are anecdotal cases of patients with cerebral palsy reporting improvement of their condition after using cannabis, but the scientific research on whether cannabis is an effective treatment for cerebral palsy is still very limited. Still, there is some evidence suggesting a correlation between the endocannabinoid system (ECS) and cerebral palsy or its causes (such cerebral ischemia and brain lesions). In addition, there is some limited research suggesting that both THC and CBD could help those with cerebral palsy find relief from symptoms such as pain, spasticity, sleep difficulty and speech disorder. So, while much more research needs to be done, cannabis does show potential as a treatment for cerebral palsy. 

How Cannabis Works on Cerebral Palsy

The endocannabinoid system exists in all vertebrates and helps regulate crucial functions such as sleep, pain, and appetite. The human body produces its own cannabinoids, which modulate and activate its various functions, but as its name suggests, the endocannabinoid system can also be modulated and activated by cannabinoids found in the cannabis plant. Because the entire system was only discovered in the past 30 years, scientists still have much to learn about the myriad ways cannabis affects the human body.

There is also evidence that the ECS may play a role in the development of cerebral palsy. For one thing, endocannabinoids have been found to have neuroprotective effects in some animal models of cerebral palsy. 

In one mouse model, for example, the endocannabinoid anandamide was able to protect the brain against developing white matter and lessen the brain lesions associated with neonatal development of cerebral palsy. This effect seems to be mediated primarily by the CB1 receptor — a key receptor in the ECS which can be activated by both endocannabinoids like anandamide, and cannabinoids from cannabis like THC. 

Other research shows that altered endocannabinoid system signaling is also involved in cerebral ischemia, a type of stroke that occurs when there is inadequate blood flow to the brain. When this happens to a baby during pregnancy, it can lead to cerebral palsy. Research studying this phenomenon has found that ECS activity can both exacerbate and reduce injury from cerebral ischemia, creating a complex picture. 

For example, some evidence suggests that activation of CB1 is beneficial during ischemia, reducing brain swelling and damage to neurons, as well as inducing hypothermia — which can be protective during ischemia. But other research suggests that CB1 activation can cause problems and reducing it’s activity has protective effects. CB2, another receptor in the endocannabinoid system, has also been found to have protective effects, so scientists reviewing the data suggest that activating CB2 while reducing activity of CB1 may be the best route for reducing damage in ischemia. Still, more research is needed to better understand how these receptors interact with the condition. 

Research on Cerebral Palsy and Cannabis 

When it comes to treating cerebral palsy with cannabis, the research is still fairly limited. Despite the many anecdotal reports of cannabis helping patients with cerebral palsy, there is very little looking at cerebral palsy specifically. Still, there are studies looking at specific symptoms that are common in cerebral palsy, such as pain and spasticity, which show that cannabis may be able to help those with cerebral palsy improve their quality of life. 

One study that looked specifically at cerebral palsy patients was a survey-based study investigating a spectrum of treatments for pain relief. This study included 83 adults with cerebral palsy and looked at 24 potential pain treatments — including cannabis. While less than 5% of those studied had tried cannabis, it was the highest rated treatment in the study — offering more relief than traditional painkillers like opioids, benzodiazepines, aspirin, and acetaminophen, and beating out drug-free care options like ice or heat, physical therapy, hypnosis, acupuncture, massage and counseling. This is highly encouraging and points to the need for more studies on the role of cannabis in helping pain in CP.

Cannabis may also help with cerebral palsy-related spasticity. In fact, there is even a history of using cannabis for spasms that goes back into the 19th century. There is also a fair bit of data supporting the use of cannabis for spasticity in multiple sclerosis

One study on patients with spasticity from conditions including cerebral palsy found that THC from cannabis reduced spasticity in 78% of those in the study. To add to this, all three patients in the study with tonic spasms (a type of spasm common for adults with cerebral palsy) saw beneficial results from using THC. 

Another study looked at cannabis for the treatment of motor disorders. The researchers studied cannabis’ effects on 25 children between the ages of one and 17 — all with motor disorders including cerebral palsy. Children taking a THC formulation for five months saw significant improvement in not only spasticity, but also sleep difficulties, pain severity, and quality of life. 

In addition, some with cerebral palsy report that cannabis can help with speech disorders, a common symptom for the condition. While there is no research on this topic, there are stories like that of Jacqueline Patterson, a woman with cerebral palsy who has suffered with severe stuttering since childhood. She reports in her 2007 documentary In Pot We Trust that cannabis significantly reduced her stuttering (along with her muscle pain and stiffness). Stories like Jacqueline’s show how important it is to continue research into cannabis’ benefits so we can understand how and why cannabis might be helping with this aspect of cerebral palsy. 

CBD and Cerebral Palsy

While most studies on cannabis and cerebral palsy relate to THC (cannabis’ most common chemical ingredient and the one known for providing a euphoric and sometimes hallucinogenic high), one study has also investigated CBD (a medicinal compound in cannabis that does not cause this type of high). 

The study looking at cannabis for the treatment of motor disorders in children, mentioned above, researched not only THC, but also CBD in their experiments. Like with THC, children taking a CBD formulation for five months also saw significant improvement in not only spasticity, but also sleep difficulties, pain severity, and quality of life. In this study, THC and CBD performed equally well in helping children with their cerebral palsy symptoms and quality of life. 

Side Effects

The side effects of cannabis are generally mild and can include symptoms like mild difficulties in concentration and memory, impaired coordination, light-headedness, racing heart, increased appetite, dry mouth, nausea, and fatigue.

When it comes to cerebral palsy, one important potential side effect that occurred in the literature was worsening of seizures. While this was rare, it did occur during the research and may impact some patients. Other side effects noted in this group were behavioral changes and drowsiness.  

In addition, cannabis may interact negatively with some drugs — slowing their metabolism and thus increasing the amount present in the bloodstream. Those taking other medications should consult with a doctor before beginning cannabis use. 

Cannabis Side Effects

Disclaimer

The Cannigma content is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Always consult with an experienced medical professional with a background in cannabis before beginning treatment.

About Cerebral Palsy

Cerebral palsy (CP) is a motor, or movement, disorder that affects someone’s ability to move. “Cerebral” means that it’s to do with the brain, and “palsy” means that it involves weakness or difficulty using the muscles. It is a muscular disorder that’s caused by damage to certain parts of the brain before birth. Cerebral palsy doesn’t get any worse during the course of someone’s life, but some of the symptoms can change over time. 

There are 4 main types of cerebral palsy:

Spastic cerebral palsy

This is the most common type of CP. 80% of people with CP have spastic CP. People who have spastic cerebral palsy have unusually stiff muscles, which makes their movements awkward and clumsy. There are 3 types of spastic CP, too:

  • Spastic diplegia/diparesis, where the legs are the worst affected but the arms are affected much less or not at all. People with spastic diplegia often find it difficult to walk, because their tight hip and leg muscles pull their legs together. 
  • Spastic hemiplegia/hemiparesis, when only one side of the body is affected. Usually, the arm is affected worse than the leg.
  • Spastic quadriplegia/quadriparesis is the most severe type of spastic CP, because it affects all four arms and legs. Most people with spastic quadriplegia can’t walk, and often have seizures, an intellectual disability, and trouble seeing, hearing, and speaking.

Dyskinetic cerebral palsy 

Dyskinetic CP includes other types of cerebral palsies, called athetoid, choreoathetoid, and dystonic CP. Dyskinetic CP means that people have trouble controlling the movement of their limbs. It’s hard for them to sit, walk, or stand, because their limbs move uncontrollably, either in a slow, writhing manner, or fast and jerkily. 

Some people with dyskinetic CP also have difficulty swallowing, talking, and sucking. When someone has dyskinetic CP, their muscle tone – meaning whether their muscles are stiff and tight or loose and floppy – can change frequently, even during the course of a single day.

Ataxic cerebral palsy

When someone has ataxic CP, they struggle with balance and coordination. This can affect their steadiness when they walk, ability to do fine motor tasks like writing, and control over their hands and arms when stretching for something.

Mixed cerebral palsy

Mixed cerebral palsy is a mixture of more than one type of CP. Most often, someone with mixed CP has spastic-dyskinetic CP.

Between 1.5 and 4 out of every 1,000 babies born worldwide have cerebral palsy. In the US, 1 out of every 323 children has been diagnosed with CP.

The effects of cerebral palsy can vary greatly. For example, one person might not be able to walk at all, while another could walk with just a little abnormality in their gait. Below are some of the symptoms of CP:

  • Muscle stiffness. For example, legs that are stiff or cross like scissors when you pick the baby up
  • Floppiness when lying down or picked up
  • Poor coordination, or in babies, not bringing their hands together or both hands to their mouth
  • Not meeting motor developmental milestones such as a delay in crawling, walking, talking
  • Favoring one side of the body, like reaching out with only one hand or dragging one leg behind when crawling
  • Uncontrolled trembling or involuntary movement
  • Excess dribbling
  • Difficulty sucking, swallowing, or eating 
  • Seizures
  • Slow, writhing movements (athetosis)

People who have cerebral palsy are more likely to also have an intellectual disability, vision and hearing problems, epilepsy, mental health issues, trouble with bladder control, oral diseases, and to be hypersensitive to touch or pain, although these issues may not be caused by CP.

Cerebral palsy is usually diagnosed in babies aged 6 to 24 months, because this is when the symptoms of floppiness, delay in walking and/or talking, and other missed developmental milestones first appear. Milder cases can be diagnosed later on.  

Diagnosing CP begins with a doctor making a full physical examination of the child, and asking the mother for a full history of the child’s health, and her pregnancy history with the baby. 

The doctor might order some medical tests, including:

  • A neurologic test to check reflexes and motor functions
  • X-rays
  • EEG, MRI, and CT scans
  • Gait laboratory analysis to assess the way that the child walks
  • Genetic testing, to check for any hereditary conditions
  • Metabolic tests for specific enzymes that are needed to keep the body functioning properly

The doctor may decide to continue to monitor the child over the next few months, in order to check how they progress, or may diagnose cerebral palsy based on the test results, history, and examinations.

Cerebral palsy is caused by damage to the developing brain, or abnormal development of the brain, in a fetus, baby, or small child. Scientists used to think that it was caused by lack of oxygen in the womb, but now they believe that only happens in a small number of cases. 

Most cerebral palsy (85-90%) is congenital, which means that it happens before or during birth. A small percentage of people with CP developed it after birth, usually because of a traumatic head injury or an infection.

Most of the time, there’s no way to know what caused congenital CP. Some of the causes include:

  • Genetic mutations
  • Maternal infections that affect the fetus as well as/instead of the mother
  • Fetal stroke, which is when blood supply to the fetus’ brain is disrupted
  • Lack of oxygen to the brain due to a difficult labor and/or birth

If the mother catches certain infections or diseases during pregnancy, it can harm the baby’s brain development and cause CP. Infections that can lead to CP include:

  • German measles (rubella)
  • Chickenpox (varicella)
  • Herpes, which can be passed from the mother to the fetus, causing the unborn baby’s nervous system to be inflamed
  • Syphilis
  • Zika virus, which can cause CP and microcephaly
  • Toxoplasmosis, which is caused by a parasite that lives in contaminated food, soil, and cat feces
  • Cytomegalovirus, which causes flu-like symptoms in the mother and can cause birth defects in an unborn child

If the mother is exposed to some toxins, like methyl mercury, or has other conditions like seizures, thyroid issues, and/or an intellectual disability, it can also raise the risk of her baby developing CP. 

If a young baby catches bacterial meningitis or viral encephalitis, or has severe, untreated jaundice, they can develop CP. 

There are certain other risk factors that can increase the chances of a baby developing cerebral palsy:

  • Babies who are in breech position (feet-first) at the beginning of labor
  • Babies with heart or breathing problems during labor and/or delivery
  • Babies with a low birth weight (under 5.5lb)
  • Multiple births, i.e., twins, triplets, or more
  • Babies born earlier than 37 weeks
  • Babies with an Rh blood type that isn’t compatible with the mother’s Rh blood type

There’s no cure for cerebral palsy, but there are ways to lessen the symptoms and make life significantly more comfortable for people who have CP. 

The earlier a child is diagnosed with CP, the more effective interventions are at improving their ability to function. Treatment plans generally include a combination of therapies, assistive living aids,  medications, and sometimes surgery too. 

Medications

Medicine can’t cure CP, but it can certainly help. Medications include:

  • Antispasmodics, to relax tight, stiff muscles and stop them from going into painful spasms
  • Anticonvulsants, which treat the seizures which often come along with CP
  • Anticholingerics that help soften extremely rigid muscles (dystonia), and reduce uncontrollable drooling
  • Botulin toxin (botox) loosens muscle tightness

Therapies

Many different therapies help children and adults with CP to enjoy a better quality of life. 

  • Speech therapy helps people with CP to control the muscles in and around their mouth, so they can talk, swallow, and eat more comfortably.
  • Physical therapy stretches out tight, painfully stiff muscles, strengthens them, and increases flexibility and mobility. It can help people with CP to walk, balance, sit, stand, grasp things, and take care of themselves.
  • Occupational therapy helps people with CP to live more independently by improving their gross motor skills, fine motor skills, and hand-eye coordination

Surgery 

Sometimes, orthopedic surgery and/or neurosurgery can help with the symptoms of CP. 

Orthopedic surgery can help release contracted muscles and shortened tendons, deal with scoliosis, dislocated hips (due to tight muscles), and deformed ankles and feet.

Neurosurgery includes implanting a baclofen pump, which releases a muscle relaxant called baclofen directly into the spinal canal, and selective dorsal rhizotomy, which cuts some nerves in the spine to improve movement and posture.

Supports and aids for living with CP

Depending on the symptoms of each person’s CP, they might find that different aids, support, and devices help them to live more comfortably and independently. 

  • Orthotic devices, like braces and splints, help support floppy limbs and a floppy torso
  • Seating and positioning aids help people to sit, lie down, or stand up with more stability
  • Eating and writing aids, like special, ergonomic forks, knives, spoons, pens, pencils, and other utensils that make it easier for people with CP to grasp them
  • Communication aids, like alphabet boards, speech-recognition software, computer communication programs, and other devices help people who have trouble talking clearly to communicate

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