The Effects of Single Event Multi-level Chemoneurolysis on Upper Extremity Function in Children with Cerebral Palsy

ABSTRACT

OBJECTIVE: To investigate the effects of single event multi-level chemoneurolysis (SEMLC) on the upper extremity function along with the improvement of spasticity in children with cerebral palsy. METHOD: SEMLC using botulinum toxin and 5% phenol solution was done for the upper extremities of 22 children with spastic cerebral palsy. In control group, 17 children with spastic cerebral palsy were enrolled. The assessment of spasticity (modified Ashworth scale) and upper extremity function (quality of upper extremity skills test, QUEST) before and 4 weeks after treatment were examined. RESULTS: The spasticity of upper extremity was significantly reduced in SEMLC group compared with control group (p<0.05). The improvement of upper extremity function was significantly greater in SEMLC group than in control group (p<0.05). Children with spastic triplegia showed the largest change of QUEST compared with other types, but it wasn't statistically significant. In SEMLC group, initial QUEST score and the degree of improvement of QUEST after treatment showed significant negative correlation (p<0.05). CONCLUSION: This study revealed SEMLC of the upper extremity in cerebral palsy was the effective treatment which could improve the upper extremity function as well as reduce the spasticity itself.