Clinical effects of botulinum toxin A and phenol block on gait in children with cerebral palsy.
OBJECTIVE
To compare the treatment effectiveness of botulinum toxin type A (BTX-A) and phenol blocks in managing lower limb spasticity and gait dysfunction in children with cerebral palsy.


METHODS
This is a case-controlled study that took place in a tertiary center's gait laboratory. A total of 27 ambulatory children with cerebral palsy spastic diplegia, aged from 3 to 7 yrs, and 20 normal children were recruited into this study. Sixteen children with cerebral palsy received BTX-A injections, and 11 received phenol motor point blocks. Gait analyses were assessed by a portable computer-assisted system (Computer DynoGraphy, Infotronic, The Netherlands). Both the BTX-A and phenol groups received gait analysis at 1 wk before and 2 mos after injection treatments.


RESULTS
Significant improvements in gait variables of velocity and cadence were noted in children with cerebral palsy after BTX-A injections as compared with the phenol block group. Gaitline and cyclogram patterns also improved significantly in the BTX-A group. The adverse clinical effects of BTX-A injections were less severe as compared with phenol injections.


CONCLUSIONS
BTX-A injections demonstrated superior treatment effects in improving gait variables and patterns in children with spastic diplegia as compared with phenol blocks. BTX-A injections also revealed fewer clinical side effects and were well tolerated by children with cerebral palsies.
Wong
Alice M K
AM
Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Kwei-Shan, Tao-Yuan, Taiwan.
Chen
Chia-Ling
CL
Chen
Carl P C
CP
Chou
Shih-Wei
SW
Chung
Chia-Ying
CY
Chen
Max J L
MJ
D019274:Botulinum Toxins, Type A / Q000008:administration & dosage*; D016022:Case-Control Studies; D002547:Cerebral Palsy / Q000150:complications*; D002648:Child; D002675:Child, Preschool; D004576:Electromyography; D005260:Female; D005684:Gait / Q000187:drug effects*; D006801:Humans; D007273:Injections, Intramuscular; D035002:Lower Extremity; D008297:Male; D009128:Muscle Spasticity / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D009465:Neuromuscular Agents / Q000008:administration & dosage*; D019148:Neuromuscular Blockade / Q000379:methods*; D019800:Phenol / Q000008:administration & dosage*; D016896:Treatment Outcome
D009465:Neuromuscular Agents; D019800:Phenol; D019274:Botulinum Toxins, Type A