2006
DOI: 10.1177/7010.2006.00225
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Botulinum Toxin A Injection for Spasticity in Diplegic-Type Cerebral Palsy

Abstract: Botulinum toxin type A can be both safe and effective in relieving spasticity in pediatric patients with cerebral palsy. In our prospective study, we evaluated the functional effect of botulinum toxin A in spastic diplegic-type cerebral palsy. Patients were examined on enrollment and at 1, 3, and 6 months after injection. Passive dorsiflexion of the ankle joint was measured using a goniometer as an angle of possible maximal dorsiflexion with the knee extended and flexed. Spasticity was graded using the Modifie… Show more

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Cited by 19 publications
(18 citation statements)
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“…Similar benefits of BT [1,2] were mentioned in literature. Patients and methods A prospective study including 60 children, aged from 2 to 18 years old, who received repeated injections of BT was conducted.…”
supporting
confidence: 84%
“…Similar benefits of BT [1,2] were mentioned in literature. Patients and methods A prospective study including 60 children, aged from 2 to 18 years old, who received repeated injections of BT was conducted.…”
supporting
confidence: 84%
“…A number of pharmacological agents and non-pharmacological treatments such as physical therapy, orthoses, and transcutaneous electrical nerve stimulation (TENS) have been tried for the treatment of spasticity and hypertonus 32 ) . Chemodenervation also called neurolysis or neuromuscular blockade are used to prevent nerve-muscle transmission with perineural injection of phenol 33 , 34 ) or ethyl alcohol 35 ) and intramuscular injection of botulinum toxin 36 , 37 , 38 , 39 , 40 , 41 ) . More invasive treatment options such as rhizotomy 42 , 43 , 44 ) and intrathecal baclofen 45 , 46 , 47 , 48 ) could be another choice for patients who are resistant to conventional treatments or have intractable spasticity.…”
Section: Discussionmentioning
confidence: 99%
“…Unlike adults, whose organisms are relatively static, children have two processes that are exclusive to childhood -growth and development -superimposed on the underlying spastic condition. Although the effects of BoNT/A are seen primarily in a reduction of hypertonia, the change in tonus can improve the child's balance, strength, motor control and fixed contractures 21 . As the child develops, the spastic muscles fail to grow as quickly as the neighboring structures, and dynamic structures are transformed into fixed contractures.…”
Section: Discussionmentioning
confidence: 99%
“…A critical assessment of the predictive factors for a good therapeutic result, the physiopathology of spasticity, the mechanism of action of BoNT/A and an understanding that a child's organism is undergoing constant change are directly related to the key elements for effective therapy using BoNT/A, namely, suitably chosen patients; clearly defined treatment objectives as a result of discussion with the patient and his/her family; and an effective long-term strategy for managing the changes that take place in a child with CP who is in a growth and development phase 21,22 .…”
Section: Discussionmentioning
confidence: 99%