ABSTRACT
AIM: To investigate the dynamic of general motor function and manual abilities in children with spastic forms of cerebral palsy (CP) after complex rehabilitation combined with single and repeated injections of botulinum toxin A (BTA). PATIENTS AND METHODS: The article presents 18 month followup of 52 patients with mono- and bilateral spastic forms of CP after single and multiple injections of botulinum toxin A and complex rehabilitation/ Patients received totally 74 injection sessions: 17 (32.7%) children--twice, 5 (9.6%) children--three times. Motor development assessment was done according to the GMFCS and GMFMS-88 scales and centile curves of normal motor development connected with these scales, hand function was classified according to the MACS scale. For the first time results of botulinum toxin therapy and rehabilitation were compared with the natural motor development of patients with different levels of motor disturbances according to centile tables. RESULTS: Patients with bilateral cerebral palsy improved slowly than hemiparetic and changes lasted for longer period. Level according to the MACS scale didn't depend on the gestational age of the patients, was higher in children with hemiparesis and changed for 1 level in 4 (7.7%) patients after the first botulinum toxin A injections.
Subject(s)
Botulinum Toxins, Type A/administration & dosage , Cerebral Palsy/drug therapy , Cerebral Palsy/rehabilitation , Motor Activity/physiology , Motor Skills/physiology , Adolescent , Child , Child, Preschool , Female , Follow-Up Studies , Humans , Injections, Intramuscular , Male , Muscle Spasticity/drug therapy , Muscle Spasticity/rehabilitation , Neuromuscular Agents/administration & dosage , Task Performance and Analysis , Time Factors , Treatment OutcomeABSTRACT
Aneurysmal bone cyst (ABC), a tumor-like destructive lesion, is characterized by the presence of cavities of different sizes, which are filled with blood, connective tissue-septated with fibroblasts, histiocytes, osteoclast multinucleated giant cells, osteoids, bone trabecules, and accompanied by high intraosseous pressure. ABC most frequently occurs in the second decade of life. ABC is located in the metaphyseal area in children, by displacing to the diaphysis during their growth. Surgery is a basic treatment for ABC. Its relapses frequently occur, which depends on the method of a surgical intervention, methodic activity, and the belonging to a risk group (including a combination of age, cyst size, process phase, and location).
