Botulinum toxin injections for pediatric patients with hereditary spastic paraparesis.
Limited information is available on the use of botulinum toxin type A injections for children with hereditary spastic paraplegia. This report includes 12 children with hereditary spastic paraplegia (mean age 4.8 +/- 2.5 years) who underwent 1 to 6 sessions of botulinum toxin A injections to the hamstrings, adductors and gastrocnemius muscles. Patients showed both improved muscle tone (mean 1.9 +/- 0.5 vs 1.18 +/- 0.33, P < .001, Ashworth Scale) and motor function (75.3 +/- 11.9 vs 77.7 +/- 11, P < .001, Gross Motor Function Measure). The effect lasted for a mean of 6.6 +/- 3.6 months. During the study period (mean 2.8 +/- 1.8 years), the preinjection Gross Motor Function Measure increased (69.2 +/- 14.7 vs 78.3 +/- 13.5, P = .005), whereas the Ashworth Scale remained stable, suggesting a prolonged effect of botulinum toxin A on motor function. The authors conclude that botulinum toxin A injections to lower limbs of pediatric patients with hereditary spastic paraplegia result in prolonged functional improvement despite the progressive nature of the disease.
Geva-Dayan
Keren
K
Pediatric Neurology Unit, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Domenievitz
Dafna
D
Zahalka
Rafat
R
Fattal-Valevski
Aviva
A
D000203:Activities of Daily Living; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage* / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D018482:Muscle, Skeletal / Q000187:drug effects* / Q000503:physiopathology; D009465:Neuromuscular Agents / Q000008:administration & dosage* / Q000009:adverse effects; D017063:Outcome Assessment, Health Care / Q000379:methods; D011788:Quality of Life; D012189:Retrospective Studies; D015419:Spastic Paraplegia, Hereditary / Q000188:drug therapy* / Q000503:physiopathology / Q000523:psychology; D016896:Treatment Outcome
D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A