Multilevel botulinum toxin type a as a treatment for spasticity in children with cerebral palsy: a retrospective study.
BACKGROUND
Cerebral palsy is the most common cause of physical disability in children. Spasticity is a disabling clinical symptom that is prevalent among patients suffering from cerebral palsy. The treatment of spasticity with botulinum toxin type A (BTX-A) is a well-established option in the interdisciplinary management of spasticity, providing focal reductions in muscle tone in cerebral palsy patients.


OBJECTIVE
The aim of this retrospective study was to describe the effect of multilevel BTX-A injections in the lower extremities, focusing mainly on gross motor function and functional status in cerebral palsy patients.


METHODS
Data from 71 cerebral palsy patients (64% male, 36% female, mean age 6.7 +/-3.2 years) were analyzed retrospectively. We used the Ashworth and Tardieu scales to evaluate the degree of spasticity. Motor function was measured by the Gross Motor Function Measure (GMFM-88), and functional status was classified by the Gross Motor Function Classification System (GMFCS I-V). Multilevel BTX-A injections were applied after sedation and with electrostimulation guidance. The evaluations were repeated every three months, and the patients were followed for six months.


RESULTS
We found that the Ashworth and Tardieu scores decreased significantly at the three-month evaluation (p<0.05) but not at the six-month evaluation (p>0.05). Although the improvement in spasticity was not maintained at the six-month evaluation, GMFM-88 scores increased significantly at the three- and six-month assessments. GMFSC levels showed no change in the three- and six-month assessments.


CONCLUSIONS
We believe that a single multilevel BTX-A injection reduces spasticity and improves motor function in children with cerebral palsy.
Unlu
Ece
E
Ministry of Health Diskapi Yildirim Beyazit Training and Research Hospital, Clinic of Physical Medicine and Rehabilitation - Ankara, Turkey.
Cevikol
Alev
A
Bal
Burcu
B
Gonen
Emel
E
Celik
Ozlem
O
Kose
Gulşen
G
D019274:Botulinum Toxins, Type A / Q000008:administration & dosage*; D002547:Cerebral Palsy / Q000150:complications*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007273:Injections, Intramuscular; D008297:Male; D009048:Motor Skills / Q000502:physiology; D009128:Muscle Spasticity / Q000188:drug therapy; D009465:Neuromuscular Agents / Q000008:administration & dosage*; D012189:Retrospective Studies
D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A