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Use of Modafinil in Spastic Cerebral Palsy

Department of Neuropsychiatry and Behavioral Science, Texas Tech University Health Sciences Center, Lubbock, TX

Walter Lajara-Nanson, MD

Department of Neuropsychiatry and Behavioral Science, Texas Tech University Health Sciences Center, Lubbock, TX

After an initial patient with cerebral palsy had an apparent dramatic reduction in spasticity when placed on modafinil, a pilot study was undertaken in 10 pediatric patients to confirm or refute the benefit of modafinil in cerebral palsy. Nine of 10 patients completed the 1-month treatment period. The study patients were treated with 50 or 100 mg of modafinil once daily in the morning. An assessment was made at baseline and at 1 month on treatment. All patients had a clinical examination, Modified Ashworth Scale scores (spasticity) determined by a physical therapist, and videotaping of ambulation. In comparing visit 1 (baseline) and visit 2 (on treatment), statistically significant improvement in the modified Ashworth Scale scores was noted in seven of the nine patients completing the study (P = .0080). A blinded review of the videotapes did not show statistically significant differences in ambulation, but the speed (ft/sec) of gait improved in six of the nine patients (P = .0192). In this study, modafinil, a newly released central stimulant for narcolepsy, showed benefit in treating spasticity in patients with cerebral palsy. A second larger, placebo-controlled, double-blinded trial is planned to confirm these initial results and observations. Modafinil appears to benefit spastic cerebral palsy by a yet to be determined mechanism ; however, a primary effect of modafinil on brainstem structures is hypothesized to reduce spasticity of central origin. (J Child Neurol 2002;17:169-172).

Journal of Child Neurology, Vol. 17, No. 3, 169-172 (2002)
DOI: 10.1177/088307380201700303


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