Efficacy of oral magnesium therapy in the treatment of chronic constipation in spastic cerebral palsy children: a randomized controlled trial

Hassanein, Sahar M A; Deifallah, Shaymaa M; Bastawy, Hend A

doi:10.1007/s12519-020-00401-0

Cited by 5 publications

(3 citation statements)

References 21 publications

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“…More than 40% of studies presented a high risk of bias or some concerns for three of the five domains evaluated: bias arising from the Ten of the 15 studies (66.7%) did not present a high risk of bias in any domain. Four studies presented some concerns only in one domain (bias in selection of the reported results) [7,12,21,23]; two presented some concerns in two domains [22,28]; and four presented some concerns in three domains [11,20,26,29]. In the five studies with high-risk domains, three presented high risk in only one domain [19,25,27], and two studies presented high risk of bias for two domains [10] (Fig 2B).…”

Section: Plos Onementioning

confidence: 98%

“…Garcı ´a-Contreras et al (2020) [10] evaluated supplementation for 28 days with probiotics, symbiotics or prebiotics compared to a placebo. Hassanein et al (2021) [26] studied supplementation with an oral solution of magnesium sulfate for 1 month compared to a placebo. Both studies found positive results of their interventions, with improvements in stool consistency and frequency (Table 4).…”

Section: Plos Onementioning

confidence: 99%

“…Regarding the use of magnesium sulfate as an intervention for constipation, the authors raised the limitation that safety data after prolonged treatment for one year were not evaluated [26]. Hypermagnesemia (values above 4 mg/dL) may lead to weakness, nausea, dizziness, confusion, decreased reflexes, worsening confusional state, drowsiness, bladder paralysis, flushing, headache and constipation.…”

Section: Plos Onementioning

confidence: 99%

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Dietary and nutritional interventions in children with cerebral palsy: A systematic literature review

Rebelo

Mansur²,

Miglioli³

et al. 2022

PLoS ONE

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Background Cerebral palsy is an extremely severe brain injury associated with multiple nutritional and clinical issues, such as underweight, gastroesophageal reflux, constipation, and nutrient deficiency. Evidence-based dietary and nutritional interventions may improve the quality of life of children with cerebral palsy. Aim Systematically review randomized clinical trials evaluating nutritional and dietary interventions in the clinical, nutritional, and neurodevelopmental aspects of children with cerebral palsy. Methods A search was performed in electronic databases (LILACS, Medline, Web of Science, Embase, Scopus, Cochrane Library, ClinicalTrials.gov, Brazilian Digital Library of Theses and Dissertations, ProQuest Dissertations and Theses Database, OpenGrey) using keywords. The search was firstly performed in May 2020 and updated on June 18th, 2021. Eligible studies were randomized clinical trials, that included children between 2 and 12 years old, and evaluated the effect of nutritional or dietetic interventions on clinical, nutritional or neurodevelopmental outcomes. Risk of bias was investigated using the RoB-2 tool. The study was registered on PROSPERO (CRD42020181284). Results Fifteen studies were selected. Positive results included the use of whey-based or pectin-enriched enteral formulas for gastroesophageal reflux (n = 6); 25-hydroxy-vitamin D supplementation for hypovitaminosis D (n = 2); supplementation with lipid mixture or diet with high-density energy for improvements in anthropometric measures (n = 2); supplementation with probiotics, prebiotics, symbiotics or magnesium for constipation (n = 2); nutritional support system for gross motor function (n = 1); lactoferrin and iron hydroxide polymaltose for iron deficiency anemia (n = 1); and educational intervention to improve feeding skills (n = 1). The overall risk of bias was high for 60% of the studies, and some concerns were raised for the remaining 40%. Conclusion Some promising dietary and nutritional interventions may promote important clinical improvements for patients with cerebral palsy. However, evidence is weak, as few clinical trials have been published with many methodological errors, leading to a high risk of bias.

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Section: Plos Onementioning

confidence: 98%

Section: Plos Onementioning

confidence: 99%

Section: Plos Onementioning

confidence: 99%

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Dietary and nutritional interventions in children with cerebral palsy: A systematic literature review

Rebelo

Mansur²,

Miglioli³

et al. 2022

PLoS ONE

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Adrenocorticotropic hormone combined with magnesium sulfate therapy for infantile epileptic spasms syndrome: a real-world study

He,

Wang,

et al. 2023

World J Pediatr

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Background Infantile epileptic spasms syndrome (IESS) is a serious disease in infants, and it usually evolves to other epilepsy types or syndromes, especially refractory or super-refractory focal epilepsies. Although adrenocorticotropic hormone (ACTH) is one of the first-line and effective treatment plans for IESS, it has serious side effects and is not sufficiently effective. Methods A retrospective study of the clinical outcomes of ACTH combined with magnesium sulfate (MgSO4) therapy for IESS in two hospital centers was conducted. The major outcome of the single and combined treatment was evaluated by changes in seizure frequency and improvements in hypsarrhythmia electroencephalography (EEG). To reduce the confounding bias between the two groups, we used SPSS for the propensity score matching (PSM) analysis. Results We initially recruited 1205 IESS patients from two Chinese hospitals and treated them with ACTH combined with MgSO4 and ACTH alone. Only 1005 patients were enrolled in the treatment (ACTH combined with MgSO4: 744, ACTH: 261), and both treatment plans had a more than 55% response rate. However, compared to patients treated with ACTH alone, those patients treated with ACTH combined with MgSO4 had better performance in terms of the seizure frequency and hypsarrhythmia EEG. After PSM, the two groups also showed significant differences in responder rate [70.8% (95% confidence interval, CI) = 66.7%–74.8%) vs. 53.8% (95% CI = 47.4%–60.2%), P < 0.001], seizure frequency (P < 0.001) and hypsarrhythmia EEG resolution (P < 0.001). Notably, multivariate analysis revealed that the lead time to treatment and the number of antiseizure medications taken before treatment were two factors that may affect the clinical outcome. Patients with less than 3 months of lead time responded to the treatment much better than those with > 3 months (P < 0.05). In addition, the overall incidence of adverse reactions in the ACTH combined with MgSO4 group was much lower than that in the ACTH group (31.4% vs. 63.1%, P < 0.001). During the treatment, only infection (P = 0.045) and hypertension (P = 0.025) were significantly different between the two groups, and no baby died. Conclusion Our findings support that ACTH combined with MgSO4 is a more effective short-term treatment protocol for patients with IESS than ACTH alone, especially for those patients with short lead times to treatment.

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Nutritional Support System (NSS) as a New Therapeutic Strategy for Cerebral Palsy

Leal-Martínez

Jimenez-Ramirez

Ibarra

2024

CNSNDDT

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Cerebral palsy (CP) is part of a group of nonprogressive motor disorders. The disease affects movement and posture and constitutes the most frequent cause of motor disability in childhood. CP is characterized by spasticity, reflecting lesions in the pyramidal pathway. Treatment is currently focused on physical rehabilitation, and the annual progression of the disease is 2-3%. About 60% of these patients present severe degrees of malnutrition associated with dysphagia, gastrointestinal abnormalities, malabsorption, increased metabolism, and depression. These alterations promote sarcopenia functional dependence and affect the quality of life and delay the evolution of motor skills. Currently, there is evidence that the supplementation of several nutrients, dietary correction, and probiotics can improve neurological response by stimulating neuroplasticity, neuroregeneration, neurogenesis, and myelination. This therapeutic strategy could shorten the response period to treatment and increase both gross and fine motor skills. The interaction of nutrients and functional foods integrating a Nutritional Support System (NSS) has shown greater efficiency in neurological stimulation than when nutrients are supplied separately. The most studied elements in the neurological response are glutamine, arginine, zinc, selenium, cholecalciferol, nicotinic acid, thiamine, pyridoxine, folate, cobalamin, Spirulina, omega-3 fatty acids, ascorbic acid, glycine, tryptophan, and probiotics. The NSS represents a therapeutic alternative that will restore neurological function in patients with spasticity and pyramidal pathway lesions, both characteristics of patients with CP.

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Efficacy of oral magnesium therapy in the treatment of chronic constipation in spastic cerebral palsy children: a randomized controlled trial

Cited by 5 publications

References 21 publications

Dietary and nutritional interventions in children with cerebral palsy: A systematic literature review

Dietary and nutritional interventions in children with cerebral palsy: A systematic literature review

Adrenocorticotropic hormone combined with magnesium sulfate therapy for infantile epileptic spasms syndrome: a real-world study

Nutritional Support System (NSS) as a New Therapeutic Strategy for Cerebral Palsy

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