RESUMEN
OBJECTIVE: To analyse the motor phenotype with a focus on bradykinesia in children with Cerebral Palsy (CP) in the setting of periventricular leukomalacia (PVL). METHODOLOGY: Analysis of a cohort of 25 children with CP and PVL. The Gross Motor Function Classification System (GMFCS) and the Manual Ability Classification System (MACS) were used to classify the severity of motor function. Spasticity was rated using the Modified Ashworth Scale (MAS), dystonia was rated using the Burke-Fahn-Marsden Scale (BFMS), and bradykinesia was rated using the Unified Parkinson's disease rating scale (UPDRS). All patients were video-recorded following a standard protocol. RESULTS: Bradykinesia was observed in 96% of patients. It was noted mainly in the limbs, and it was moderate-to-severe in the legs and mild-to-moderate in the arms. Bradykinesia correlated with functional level, as classified by GMFCS and MACS; also with dystonia, as rated by BFMS but did not correlate with a measure of spasticity (MAS). CONCLUSIONS: This study confirms the existence of bradykinesia in patients with CP in the setting of PVL. Bradykinesia and dystonia appear to be important interrelated factors influencing the level of gross and fine motor skills in patients with PVL.
Asunto(s)
Parálisis Cerebral , Distonía , Trastornos Distónicos , Leucomalacia Periventricular , Niño , Humanos , Recién Nacido , Hipocinesia/diagnóstico , Hipocinesia/etiología , Destreza Motora , Leucomalacia Periventricular/complicaciones , Espasticidad Muscular , Índice de Severidad de la EnfermedadAsunto(s)
Miastenia Gravis/cirugía , Complicaciones Posoperatorias/fisiopatología , Timectomía/efectos adversos , Timoma/etiología , Antiinflamatorios/uso terapéutico , Anticuerpos/sangre , Humanos , Estudios Longitudinales , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Miastenia Gravis/tratamiento farmacológico , Complicaciones Posoperatorias/patología , Prednisolona/uso terapéutico , Receptores Colinérgicos/inmunologíaRESUMEN
INTRODUCTION: We aimed to determine the effect of different botulinum toxin-A (BTX-A) dilutions on the treatment efficacy and side effects for amyotrophic lateral sclerosis (ALS) related sialorrhea. METHODS: Ten patients were enrolled in the study. BTX-A dilution for Group A was 100 U in 1 ml of saline, whereas the dilution for Group B was 100 U in 2 ml of saline. Both groups received 20 U of BTX-A in each parotid gland, and assessments were made by means of the Drooling Impact Scale, items 1 and 3 of the ALS functional rating scale, and visual analog scales for drooling and swallowing function. RESULTS: Although both groups exhibited a similar improvement in drooling, Group B had a mild but significant deterioration in bulbar function that was not evident in Group A. CONCLUSIONS: These results suggest that BTX-A has a safer profile when reconstituted with 1 ml instead of 2 ml of saline.
