title: [Visual neurorehabilitation of patients with cerebral damage using botulinum toxin].
abstract: BACKGROUND
  The neurorehabilitation of the patient with cerebral damage implies the reestablishment of the visual functions. Botulinum toxin can be considerate as a less invasive alternative for treatment.
  
  
  OBJECTIVE
  to demonstrate the answer to the treatment using botulinum toxin of the visual motor alterations in patients with cerebral damage.
  
  
  METHODS
  Descriptive study of patients with visual alterations associated to cerebral damage. The visual treatment included three areas: sensorial, refracting and motor under quimiodenervation with botulinum toxin, of May 2009 to May 2010.
  
  
  RESULTS
  48 patients were studied, age 22,4 years ± 23. The strabismus were: esotropia 52%, exotropia 39,5%, vertical 8%, nystagmus 4%. 50% of the patients had psychomotor delay. Some of the most important causes of cerebral damage were: Down syndrome, epilepsy, tumor, hydrocephalus, neuroinfection, infantile cerebral paralysis, multiple sclerosis, metabolic syndrome, cranial trauma, congenital cardiopathy, ventricular hemorrhage, cerebrovascular stroke. The dose of botulinum toxin was 8,1 UI ± 3. We registered good results in 56.5%, regular 23,9% and bad 19,5%. The global percentage of rehabilitation was 69% of correction with a r of Pearson of 0,5.
  
  
  CONCLUSIONS
  Patients with cerebral damage have diverse types of visuomotor alterations, strabismus and nystagmus.Use of botulinum toxin as a paralytic muscle agent is a good alternative in these cases.
  
  
  CONCLUSIONS
  The botulinum toxin is an effective option for the visual rehabilitation in patients with cerebral damage and prevents the progression of more cerebral changes secondary to strabismus.
authors: Servicio de Oftalmología, Departamento de Estrabismo. Centro Médico Nacional 20 de Noviembre, ISSSTE, México, D.F., Mexico. smoguel@prodigy.net.mx
authors: Silvia
authors: S
authors: Moguel-Ancheita
authors: Adriana
authors: A
authors: Valdés-Barrena
authors: Fátima Guadalupe
authors: FG
authors: Padilla-Sánchez
mesh_terms: D000328:Adult; D000368:Aged; D019274:Botulinum Toxins, Type A; D001925:Brain Damage, Chronic / Q000150:complications* / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009407:Nerve Block; D009759:Nystagmus, Pathologic / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D009801:Oculomotor Muscles / Q000294:innervation / Q000503:physiopathology; D009886:Ophthalmoplegia / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D011446:Prospective Studies; D011596:Psychomotor Disorders / Q000150:complications / Q000503:physiopathology; D013285:Strabismus / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D019274:Botulinum Toxins, Type A