[Botulinum toxin A in the treatment of infantile cerebral palsy. Taking into account multilevel, integrated treatment].
Botulinum toxin A represents a significant development in the management of children and adolescents with spastic cerebral palsy. Prerequisites for an adequate result are a correct indication, an exact injection technique and an intensive post-treatment programme. Spastic muscle overactivity and the constant tendency of the involved muscles to shorten with growth cannot be treated by only one method. Therefore a multilevel approach and an integrated treatment schedule including plaster of Paris, orthoses and physiotherapy are currently the best ways to modify the disease process. The inclusion of objective clinical documentation techniques combined with 3-D instrumented gait analysis allows the determination of the indications more exactly and for monitoring the post-treatment results. If started early and correctly, this integrated management approach has the potential to modify the natural history of the disorder, and to reduce the frequency of later surgery.
Heelkunde-Orthopedie, University Hospital Pellenburg, Weligerveld 1, 3212 Pellenburg, Belgium. Guy.Molenaers@uz.kuleuven.ac.be
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D000328:Adult; D000818:Animals; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D002370:Casts, Surgical; D002547:Cerebral Palsy / Q000188:drug therapy / Q000628:therapy*; D002648:Child; D003131:Combined Modality Therapy; D005081:Exercise Therapy; D006801:Humans; D007273:Injections, Intramuscular; D009465:Neuromuscular Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D009989:Orthotic Devices; D013997:Time Factors; D016896:Treatment Outcome
D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A