Comparison of Efficacy and Side Effects of Oral Baclofen Versus Tizanidine Therapy with Adjuvant Botulinum Toxin Type A in Children With Cerebral Palsy and Spastic Equinus Foot Deformity

Dai, Alper; Aksoy, Şefika; Demiryürek, Abdullah Tuncay

doi:10.1177/0883073815587030

Cited by 21 publications

(37 citation statements)

References 36 publications

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“…InStat (GraphPad, USA) was used for statistical analysis. The independent-samples chi-square test and one-way analysis of variance (ANOVA) were performed for categorical and continuous data of demographic characteristics at the time of enrollment (99% of confidence level) [ 6 ]. All data were evaluated twice for reliability.…”

Section: Methodsmentioning

confidence: 99%

“…The strategy for treatment depends on the level of functional failure of the spasticity and its location. At present, baclofen (gamma-aminobutyric acid b agonist, a central muscle relaxant) [ 5 ] is used in systematic spasticity [ 6 ] and local intramuscular injection of botulinum toxin type A (acetylcholine inhibitor, a peripheral muscle relaxant) [ 7 ] in conjunction with appropriate physical therapy is used in focal dystonia and rigidity in hemiplegic or diplegic spasticity [ 1 ].…”

Section: Introductionmentioning

confidence: 99%

“…However, it is a systemic, not a focal, treatment. It can cause weakness of the spastic limbs, sedation, dizziness, fatigue, headache, and ataxia [ 6 ]. Its sustained use may cause drug addiction, and sudden withdrawal can cause hallucinations and seizures [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

“…Botulinum toxin is derived from Clostridium botulinum [ 8 ]. It takes a long time (100–115 days) for significant improvement in spasticity, and repeated treatment is also required [ 6 ]. Moreover, it can produce dose-related weakness of skeletal muscles by decreasing the release of acetylcholine at the neuromuscular junction [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

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Efficacy and Safety of Botulinum Toxin Type A in Spasticity Caused by Spinal Cord Injury: A Randomized, Controlled Trial

2018

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BackgroundBaclofen is approved by the US FDA to treat spasticity, but its sustained use may cause drug addiction. The objective of this study was to compare the efficacy and safety of botulinum toxin type A versus baclofen in spasticity.Material/MethodsA total of 336 patients who had spasticity caused by spinal cord injury were enrolled in a randomized (in 1: 1: 1: ratio) for placebo, controlled trial. Patients had received baclofen (BA group, n=112), local intramuscular injection of 500 U Botulinum toxin type A (BTI group, n=112), or physical therapies alone (placebo group, n=112). Modified Ashworth scale (mAS) score, disability assessment scale (DAS) score, modified medical research council (mMRC) score, the Barthel Index (BI) score, and treatment-emergent adverse effects were evaluated during the follow-up period. Wilcoxon test or one-way ANOVA/Tukey post hoc tests were performed at 95% of confidence level.ResultsBaclofen (1.504±0.045 vs. 1.53±0.06, p=0.003, q=4.068) and botulinum toxin type A (1.49±0.09 vs. 1.528±0.15, p=0.0224, q=3.5541) had improved mAS scores after 2 weeks. Baclofen had a more strongly improved DAS score than botulinum toxin type A at 4 (p=0.0496, q=3.48) and 6 (p<0.0001, q=6.48) weeks. Baclofen and botulinum toxin type A had consistently improved BI scores. Baclofen caused asthenia and sleepiness, while botulinum toxin type A caused bronchitis and elevated blood pressure.ConclusionsBotulinum toxin type A may be an effective therapeutic option for spasticity caused by spinal cord injury.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Efficacy and Safety of Botulinum Toxin Type A in Spasticity Caused by Spinal Cord Injury: A Randomized, Controlled Trial

2018

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“…Data reported from several retrospective studies and systematic reviews shows that the conventional treatments used to treat CP and its associated symptoms such as botox, baclofen to control muscle spasms and seizures, glycopyrrolate to control drooling and pamidronate to control osteoporosis are not the effective treatments to cure it permanently [32][33][34]. These treatments have limitations to treat CP at GMFCS levels IV and V only [35].…”

Section: Discussionmentioning

confidence: 99%

Improved Epilepsy and Speech Outcomes with Human Embryonic Stem Cell Therapy in Children with Cerebral Palsy

Shroff¹

2016

Int Arch Med

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Introduction: Cerebral Palsy (CP) is a group of permanent neurological disorders which is prevalent in children of neonatal age and is often associated with epilepsy and speech disorders. The various conventional treatments and therapies available so far are unable to treat these comorbidities. In this study, we aimed to evaluate 101 patients with CP having speech disorders and epilepsy. The patients were treated using human embryonic stem cells (hESC) therapy and assessed by Gross Motor Function Classification System-Expanded and Revised (GMFCS-E & R) score. Materials and Methods: Patients were given hESCs via different routes of administration for duration of 8 weeks and evaluated before and after the treatment on the basis of their levels of gross and motor function of improvement, i.e., frequency of the epileptic attacks and ability to speak. Single photon emission computed tomography (SPECT) scan investigations were also performed to support the studies. Results: There was an improvement in 96.61% of the epileptic patients and 91.39% of the patients with speech disorder. Of 59 patients affected with epilepsy, 18 patients had shown complete disappearance of epileptic episodes; and of 93 patients affected with speech, 27 patients became completely verbal. Conclusion: Hence, hESC therapy might be beneficial in patients with CP having epilepsy and speech disorders.

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Current therapies and therapeutic decision making for childhood‐onset movement disorders

2019

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Movement disorders differ in children to adults. First, neurodevelopmental movement disorders such as tics and stereotypies are more prevalent than parkinsonism, and second, there is a genomic revolution which is now explaining many early‐onset dystonic syndromes. We outline an approach to children with movement disorders starting with defining the movement phenomenology, determining the level of functional impairment due to abnormal movements, and screening for comorbid psychiatric conditions and cognitive impairments which often contribute more to disability than the movements themselves. The rapid improvement in our understanding of the etiology of movement disorders has resulted in an increasing focus on precision medicine, targeting treatable conditions and defining modifiable disease processes. We profile some of the key disease‐modifying therapies in metabolic, neurotransmitter, inflammatory, and autoimmune conditions and the increasing focus on gene or cellular therapies. When no disease‐modifying therapies are possible, symptomatic therapies are often all that is available. These classically target dopaminergic, cholinergic, alpha‐adrenergic, or GABAergic neurochemistry. Increasing interest in neuromodulation has highlighted that some clinical syndromes respond better to DBS, and further highlights the importance of “disease‐specific” therapies with a future focus on individualized therapies according to the genomic findings or disease pathways that are disrupted. We summarize some pragmatic applications of symptomatic therapies, neuromodulation techniques, and some rehabilitative interventions and provide a contemporary overview of treatment in childhood‐onset movement disorders. © 2019 International Parkinson and Movement Disorder Society

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Comparison of Efficacy and Side Effects of Oral Baclofen Versus Tizanidine Therapy with Adjuvant Botulinum Toxin Type A in Children With Cerebral Palsy and Spastic Equinus Foot Deformity

Cited by 21 publications

References 36 publications

Efficacy and Safety of Botulinum Toxin Type A in Spasticity Caused by Spinal Cord Injury: A Randomized, Controlled Trial

Efficacy and Safety of Botulinum Toxin Type A in Spasticity Caused by Spinal Cord Injury: A Randomized, Controlled Trial

Improved Epilepsy and Speech Outcomes with Human Embryonic Stem Cell Therapy in Children with Cerebral Palsy

Current therapies and therapeutic decision making for childhood‐onset movement disorders

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