Use of botulinum toxin in pediatric spasticity (cerebral palsy).
Local injection of botulinum toxin (BT) is a well-established treatment option for spastic movement disorders in children. BT blocks the release of acetylcholine from the axon terminal into the synaptic cleft of the motor endplate resulting in paresis of the injected musculature. Such localised, temporary chemodenervation of affected muscles can lead to functional gains and may improve the child's daily routine and rehabilitative care. We summarise state-of-the-art treatment of spasticity in children with BT type A, addressing critical issues and introducing recent advances, such as sonography-guided injection of BT and the distal injection of the psoas muscle without the need for general anaesthesia. First-hand experience with BT type B in children is presented.
Berweck
Steffen
S
Children's University Hospital, Munich, Germany.
Heinen
Florian
F
D001905:Botulinum Toxins / Q000627:therapeutic use*; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D001921:Brain / Q000187:drug effects / Q000473:pathology; D002547:Cerebral Palsy / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D007273:Injections, Intramuscular; D008279:Magnetic Resonance Imaging / Q000379:methods; D009465:Neuromuscular Agents / Q000627:therapeutic use*; D010372:Pediatrics / Q000379:methods; D013997:Time Factors; D014463:Ultrasonography / Q000379:methods
D009465:Neuromuscular Agents; C096323:rimabotulinumtoxinB; D001905:Botulinum Toxins; D019274:Botulinum Toxins, Type A