[Botulinum toxin treatment for horizontal strabismus in children with cerebral palsy].
To evaluate the efficacy of botulinum toxin injection in the treatment of horizontal strabismus in children with cerebral palsy.


METHODS
A group of 24 patients, age 6 - 156 months, with cerebral palsy and horizontal strabismus (17 esotropias ranging from 25 to 45 PD and 7 exotropias ranging from 20 to 45 PD) were treated with botulinum toxin (34 medial rectus and 14 lateral rectus muscles). The children underwent full ophthalmic examination. The injection treatment was performed after sedation using Mendonça's forceps. The follow-up was done after 7 days, 15 days and monthly. Deviation less or equal of 10 PD after 6 months of follow-up was considered successful. However, if patients did not achieve this result a second application could be performed.


RESULTS
In the group of esotropia (n=17) 47.1% had successful results with only one application after two years of follow-up. All of these patients had previous deviation less than or equal to 35 PD. In the exotropia group a single injection was not sufficient to achieve successful result. The side effects included: subconjutival hemorrhage in 4 (16.7%) patients, transient vertical deviation in 4 (16.7%) and transient ptosis in 22 (91.7%).


CONCLUSIONS
The use of botulinum toxin was a good alternative in the treatment of children with cerebral palsy and esotropia.
Cronemberger
Mônica Fialho
MF
Universidade Federal de São Paulo, São Paulo, SP, Brasil. mfcronemberger@uol.com.br
Mendonça
Tomás Scalamandré
TS
Bicas
Harley Edison do Amaral
HE
D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D002547:Cerebral Palsy / Q000150:complications*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D009465:Neuromuscular Agents / Q000627:therapeutic use*; D011446:Prospective Studies; D013285:Strabismus / Q000188:drug therapy* / Q000209:etiology; D016896:Treatment Outcome
D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A