Botulinum toxin type a in the treatment of children with congenital muscular torticollis.
This is a retrospective case series describing the use of botulinum toxin type A in the treatment of children with congenital muscular torticollis who fail to progress with conservative management. A total of 27 children with congenital muscular torticollis, 6-18 mos of age, received 30 botulinum toxin type A injections into their sternocleidomastoid or upper trapezius muscle, or both, at a pediatric tertiary care center between 1995 and 2001. Three children received repeat injections. Twenty of 27 children (74%) had improved cervical rotation or head tilt after the injections, and 2 of 27 (7%) experienced transient adverse events, specifically, mild dysphagia and neck weakness. This series suggests that botulinum toxin type A may be a safe and effective treatment option for children with congenital muscular torticollis who are unresponsive to a traditional regimen of physical therapy and a home program. A prospective, randomized controlled trial is necessary to definitively assess the role of botulinum toxin type A in this population.
Oleszek
Joyce L
JL
Department of Physical Medicine and Rehabilitation, Children's Hospital, Denver, Colorado 80218, USA.
Chang
Nicki
N
Apkon
Susan D
SD
Wilson
Pamela E
PE
D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007273:Injections, Intramuscular; D008297:Male; D020127:Recovery of Function; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D014103:Torticollis / Q000151:congenital* / Q000175:diagnosis / Q000188:drug therapy*; D016896:Treatment Outcome
D019274:Botulinum Toxins, Type A