title: Spread of botulinum neurotoxin type a at standard doses is inherent to the successful treatment of spastic equinus foot in cerebral palsy: short-term neurophysiological and clinical study.
abstract: To evaluate whether botulinum toxin type A at standard doses spreads to antagonist leg muscles in dynamic equinus foot, we studied 18 ambulatory children with hemiplegic cerebral palsy. The gastrocnemius muscle on the affected side was injected with botulinum toxin type A (Dysport) (mean ± standard deviation, 14.3 ± 0.9 U/kg). Compound muscle action potential areas were assessed in the lateral gastrocnemius and tibialis anterior muscles on the treated and untreated sides before botulinum toxin type A injections and on days 10 and 30 after injections. In all patients, compound muscle action potential areas recorded from both the muscles on the treated side decreased from preinjection values at day 10 (P < .05) and 30 (P < .002). After injection, ankle spasticity had diminished (P < .05), equinus foot excursion increased (P < .05), and functional gait improved (P < .05). This study shows that botulinum toxin type A spreads from foot flexors to antagonist extensors and suggests that spread may be partly responsible for improving gait in children with cerebral palsy.
authors: Department of Neurology, ULSS15 Cittadella Hospital, Padua, Italy. efrasson@ulss15.pd.it
authors: Emma
authors: E
authors: Frasson
authors: Elisa
authors: E
authors: Dall'ora
authors: Monia
authors: M
authors: Bordignon
authors: Francesco
authors: F
authors: Brigo
authors: Pierluigi
authors: P
authors: Tocco
authors: Daniela
authors: D
authors: Primon
authors: Giuseppe
authors: G
authors: Didonè
authors: Silvana
authors: S
authors: Vicentini
authors: Antonio
authors: A
authors: Fiaschi
authors: Laura
authors: L
authors: Bertolasi
mesh_terms: D000200:Action Potentials / Q000187:drug effects*; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D002547:Cerebral Palsy / Q000150:complications / Q000188:drug therapy; D002648:Child; D002675:Child, Preschool; D004576:Electromyography; D004863:Equinus Deformity / Q000188:drug therapy* / Q000209:etiology; D005260:Female; D006801:Humans; D007866:Leg / Q000294:innervation; D008297:Male; D018482:Muscle, Skeletal / Q000187:drug effects* / Q000503:physiopathology; D009465:Neuromuscular Agents / Q000627:therapeutic use*; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A