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Spasticity treatment is one of the key aspects of the contemporary cerebral palsy (CP) rehabilitation that influences on the effectiveness of other methods. The paper presents the first Russian document that unites the recommendations for the BTA treatment of CP and could be used as the guideline for the multilevel injections. The Russian consensus on the multilevel botulinum toxin A (BTA) treatment of spastic CP is based on the international data and the results of national studies. The authors describe typical CP spasticity patterns in the upper and lower extremities, give recommended intervals for the BTA (Abobotulinum toxin A) dosages for the whole injection procedure and for the separate muscles. The method of dosage calculation for functional segments is also described. Attention is paid to the frequency, optimal intervals between the repeated injections and the whole duration of BTA treatment. The authors discuss effectiveness and safety of BTA, factors that potentially influence the results of the injections, including ultrasound and electromyography control, and indications for the continuation and termination of treatment.

The purpose of this studyis to evaluate the ability of L-tryptophan used in complex therapy of delayed psycho-speech development in children to influence the dynamics of cognitive performance.Materials and methods. The study included 80 children aged 3–7 years with delayed psycho-speech development (DPSD). The main group consisted of 37 children (25 male and 12 female), a control group – 43 patients (30 male and 13 female). Both groups of children were comparable in age, sex, degree of speech and cognitive impairment, and IQ level. Patients in the main group have taken standard therapy with L-tryptophan (25–50 mg per day depending on the age) supplement for 14 days. Control patients have taken standard therapy only. Psychodiagnostic tests at the entrance and exit of patients from this study was carried out for evaluation the dynamics of cognitive functions. All differences were considered significant at p < 0.05.Results. The study suggests that oral L-tryptophan intake selectively affects the dynamics of cognitive performance in children with DPSD. So, we studied pre- and post-treatment cognitive performance in both group patients and noted a significant improvement in the visual memory (p < 0.001) and an increase in thinking productivity (p < 0.001) in the tryptophan group versus similar indicators in the control group. Intergroup differences (p < 0.001 and p = 0.026, respectively, for the main and control groups) also found.Conclusion. Two-week L-tryptophan intake in complex therapy of DPSD in children can significantly improve the cognitive activity, and greatly increase both the effectiveness and sustainability of treatment outcomes, which will significantly reduce the time and frequency of hospitalization and financial costs for the rehabilitation of this patients.