[Botulinum toxin in infantile cerebral palsy]. / Toxina botulínica en la parálisis cerebral infantil.

INTRODUCTION: A number of studies have proved the effectiveness and safety of botulinum toxin in therapeutic doses. AIM: To analyse the results obtained over a 12-year period in which botulinum toxin type A (BTA) was used to treat infantile cerebral palsy (CP). PATIENTS AND METHODS: Of a total number of 547 patients who were treated, 515 had CP, 464 with spasticity, 46 with mixed CP and 5 with dyskinetic CP with focal dystonia. RESULTS: Overall evaluation of BTA is positive, both as regards its beneficial effects and its safety: tone was mildly improved in 18.5% of patients, with no change in motor functioning, 39% showed a moderate improvement, 19% a marked improvement and 5.6% experienced a marked and prolonged improvement. Forty-two patients (8.15%) presented side effects, the most common being weakness in the lower limbs, which occurred in 21 cases. CONCLUSIONS: BTA is a good therapeutic option for treating children with CP, not only for the focal involvement but also as palliative treatment in children with diffuse involvement.

Toxina botulínica en la parálisis cerebral infantil / Botulinum toxin in infantile cerebral palsy

Introducción. Numerosos estudios han demostrado la eficacia y la seguridad de la toxina botulínica en dosis terapéuticas.Objetivo. Analizar los resultados obtenidos durante 12 años de utilización de la toxina botulínica de tipo A (TBA) para el tratamiento de la parálisis cerebral (PC) infantil. Pacientes y métodos. De 547 pacientes tratados, 515 presentaban PC, 464 con espasticidad, 46 con PC mixta y 5 con PC discinética con distonía focal. Resultados. La valoración global de la TBA es positiva, tanto por sus efectos beneficiosos como por su seguridad: el 18,5% de los pacientes presentó una mejoría leve en el tono, sin cambio en la función motriz, el 39% presentó una mejoría moderada, el 19% una mejoría marcada y el 5,6% una mejoría marcada y prolongada. Cuarenta y dos pacientes (8,15%) presentaron efectos secundarios, de los cuales la debilidadde las extremidades inferiores fue el más frecuente, presente en 21casos. Conclusiones. La TBA constituye una buena opción terapéutica para el tratamiento de niños con PC, no sólo para la afectación focal, sino también como tratamiento paliativo en niños con afectación difusa

Introduction. A number of studies have proved the effectiveness and safety of botulinum toxin in therapeutic doses.Aim. To analyse the results obtained over a 12-year period in which botulinum toxin type A (BTA) was used to treat infantile cerebral palsy (CP). Patients and methods. Of a total number of 547 patients who were treated, 515 had CP, 464 with spasticity,46 with mixed CP and 5 with dyskinetic CP with focal dystonia. Results. Overall evaluation of BTA is positive, both as regards its beneficial effects and its safety: tone was mildly improved in 18.5% of patients, with no change in motor functioning, 39% showed a moderate improvement, 19% a marked improvement and 5.6% experienced a marked and prolonged improvement. Forty-two patients (8.15%) presented side effects, the most common being weakness in the lower limbs, which occurred in 21 cases. Conclusions. BTA is a good therapeutic option for treating children with CP, not only for the focal involvement but also as palliative treatment in children with diffuse involvementu

[Clinical characteristics and progress of patients with migrainous headaches monitored in the Headache Unit in a paediatric referral hospital]. / Características clínicas y evolución de los pacientescon cefalea migrañosa seguidos en la Unidad deCefaleas de un hospital pediátrico de referencia.

AIM: To analyse the clinical characteristics and course of migraine patients who were attended in the Headache Unit of a paediatric referral hospital. PATIENTS AND METHODS: We conducted a retrospective observational study of children monitored in the Headache Unit of the Neurology Service who satisfied the International Headache Society diagnostic criteria for migraine, with a follow-up lasting more then six months. The following were excluded from the study: patients who failed to comply with the treatment or clinical monitoring, or whose medical data were incomplete. RESULTS: There was a predominance of patients aged between 7 and 12 years, with no differences as regards sex. Bilateral and frontal migraine without aura predominated (74%), with episodes lasting between 3 and 12 hours, and the throbbing type accounted for 45% of cases. The most common accompanying symptoms were photophobia (86%) and phonophobia (88%). Except for the second visit, the tendency of the group without prophylactic treatment was favourable. When prophylactic treatment was indicated, a favourable response was observed (p < 0.05), and no significant differences were found as regards the type of medication employed. A total of 73% of the patients were discharged, and most of them required three visits; 30% of the patients treated reported some kind of side effects. CONCLUSIONS: Migraine at the paediatric age is characterised by short but intense episodes of headache that are mostly located in the frontal area. Progress is satisfactory without pharmacological measures in a high percentage of patients. When prophylactic medication was required (due to the patient's presenting frequent episodes of migraine with high scores on the PedMIDAS rating scale), a favourable response was obtained (p < 0.05), with some side effects.