ABSTRACT
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.
Subject(s)
Botulinum Toxins, Type A/therapeutic use , Cerebral Palsy/drug therapy , Neuromuscular Agents/therapeutic use , Adolescent , Child , Child, Preschool , Humans , InfantABSTRACT
INTRODUCTION: Since introduction for clinical in the 80s, the botulinum toxin type A is being used with effectiveness in the treatment of different disorders that goes with exaggerated muscular activity. Numerous studies have been demonstrated useful for focal treatment of spasticity. PATIENTS AND METHODS: Some indications of the botulinum toxin type A for the treatment of the cerebral palsy are reviewed, emphasizing that it use must be in a global planning. The positive results and adverse events are reviewed, of a series of 278 patients with spastic cerebral palsy. RESULTS: 19% of these patients have had a slightly positive answer, with modification of the tone but without functional repercussion, 49% have had a moderate answer, 17.5% have a good improvement and a 5% have presented good improvement for a long time. Of 224 patients with more than a year of evolution, the 9.5% have presented adverse reactions, but they have always been slight and transient. CONCLUSION: The botulinum toxin type A can be considered effective and safe for the treatment of spasticity, whenever the indication is correct and it is accompanied by a treatment of physiotherapy well oriented.
Subject(s)
Botulinum Toxins, Type A/therapeutic use , Cerebral Palsy/drug therapy , Muscle Spasticity/drug therapy , Neuromuscular Agents/therapeutic use , Botulinum Toxins, Type A/adverse effects , Cerebral Palsy/physiopathology , Humans , Muscle Spasticity/physiopathology , Neuromuscular Agents/adverse effects , Treatment OutcomeABSTRACT
Introducción. Desde su introducción para uso clínico en los años 80, la TBA se utiliza con eficacia en el tratamiento de distintos trastornos que cursan con actividad muscular exagerada. Múltiples estudios han demostrado su utilidad para el tratamiento local de la espasticidad. Pacientes y métodos. Se revisan algunas indicaciones de la TBA para el tratamiento de la PCI espástica, y se destaca que su uso debe formar parte de un planteamiento global. Se resumen los resultados positivos de una serie de 278 pacientes con PCI espástica, tratados con TBA, así como los efectos adversos. Resultados. El 19% de estos pacientes presentaron una respuesta ligeramente positiva, con modificación del tono, pero sin repercusión funcional, el 49% objetivó una respuesta moderada, el 17,5%, una mejoría marcada, y un 5% mostró mejoría marcada y por un tiempo prolongado. De 224 pacientes con más de un año de evolución, el 9,5% presentaron efectos adversos, leves y transitorios en todos los casos. Conclusión. La TBA puede considerarse eficaz y segura en dosis terapéuticas, siempre que la indicación sea correcta y se acompañe de un tratamiento de fisioterapia bien orientado (AU)
Introduction. Since introduction for clinical in the 80s, the botulinum toxin type A is being used with effectiveness in the treatment of different disorders that goes with exaggerated muscular activity. Numerous studies have been demonstrated useful for focal treatment of spasticity. Patients and methods. Some indications of the botulinum toxin type A for the treatment of the cerebral palsy are reviewed, emphasizing that it use must be in a global planning. The positive results and adverse events are reviewed, of a series of 278 patients with spastic cerebral palsy. Results. 19% of these patients have had a slightly positive answer, with modification of the tone but without functional repercussion, 49% have had a moderate answer, 17.5% have a good improvement and a 5% have presented good improvement for a long time. Of 224 patients with more than a year of evolution, the 9.5% have presented adverse reactions, but they have always been slight and transient. Conclusion. The botulinum toxin type A can be considered effective and safe for the treatment of spasticity, whenever the indication is correct and it is accompanied by a treatment of physiotherapy well oriented (AU)
