[Botulin toxin as treatment for spasticity and dystonia in infantile cerebral paralysis].
Treatment of spasticity and dystonía in PCI with Botulinum toxin A.


BACKGROUND
Botulinum-A (NxTxBoA) toxin produce neuromuscular blockade, it has been effective with therapeutic purposes in strabismus, focal dystonias and spasticity.


OBJECTIVE
Evaluate the therapeutically effects off NxTxBoA in cerebral palsy (CP) spastic and/or dystonic in children. Prospective study.


METHODS
12 CP patients (8 spastic and 4 spastic/dystonic) were treated with NxTxBoA in affected muscles at least for 2 doses by up 12 months. The indication was: improve limb function, to avoid surgical correction or improve hygienic or dressing. Ashworth Spasticity Scale (ASS), functional scale for Dystonic Sindou-Millet (SMS) and O'Brien Global Assessment Scale (OGAS) were used to evaluate improvement.


METHODS
No parametric tests, Wilcoxon's rang's test and sign test were used with p < 0.05.


RESULTS
Total doses session was 3-10 U/kg. AAS showed muscle spasticity improvement in two grades in 8 patients, and one grade in the rest (p = 0.004). SMS showed the muscle dystonic improve up 60% in two patients improve 50% in others (p = 0.006). OGAS demonstrated a good correlation. Mean treatment effect during 4.8 months (rank 4 to 10 m). Two patients had side effects, general weakness, instability, and focal haematoma.


CONCLUSIONS
Botulinum toxin type A proved a highly useful adjuvant therapy and conservative management in CP.
Aguilar-Rebolledo
F
F
Unidad de Investigación en Epidemiología Clínica Hospital de Pediatría CMN SXXI IMSS, Cuauhtémoc 330, Delegación Cuauhtémoc, C.P. 06420. fran_aguilar_invest@yahoo.com.mx
Hernández-Sánchez
J
J
Rayo-Mares
D
D
Soriano-Fonseca
F
F
García-Muñoz
L
L
Ruiz-Ponce
J
J
Garrido-Ramírez
E
E
D000293:Adolescent; D000328:Adult; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D002547:Cerebral Palsy / Q000150:complications / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D004421:Dystonia / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D009128:Muscle Spasticity / Q000188:drug therapy / Q000209:etiology; D009465:Neuromuscular Agents / Q000627:therapeutic use*; D011446:Prospective Studies
D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A