RESUMO
The objective is to study the effect of dysport injections on the clinical and electromyographic changes in 35 patients (mean age 5,3+/-2,0 years) with spastic forms of cerebral palsy (26 with spastic diplegia, 9 with hemiparetic form) with equinus and equinovarus deformity. Depending on the clinical situation, dysport was injected in a total dose of 20-30 u per 1 kg of the body mass. Gastrocnemius muscles were injected more frequently than soleus and posterior tibial muscles. The treatment resulted in the significant reduction of spasticity on the Ashworth scale, decrease of equinus deformity, positive changes in the parameters of stepping on flat foot, independent standing and walking, the beginning of support period from the heel. During the arbitrary contraction, the amplitude of bioelectrical activity of target muscles of low extremities reduced, though not to the extent of the motor activity loss; the reciprocity coefficient decreased from 0,69+/-0,32 to 0,47+/-0,28 in patients with spastic diplegia and from 0,45+/-0,34 to 0,34+/-0,25 in patients with hemiparetic form. The effect of dysport was higher in hemiparetic form compared to spastic diplegia. The best results for spastic diplegia were revealed in patients with isolated spasticity without severe disturbances of reciprocal relations in shin muscles and pathological synkinesia.
Assuntos
Toxinas Botulínicas Tipo A/uso terapêutico , Paralisia Cerebral/complicações , Pé Torto Equinovaro/tratamento farmacológico , Pé Equino/tratamento farmacológico , Toxinas Botulínicas Tipo A/administração & dosagem , Paralisia Cerebral/fisiopatologia , Criança , Pré-Escolar , Pé Torto Equinovaro/etiologia , Eletromiografia , Pé Equino/etiologia , Feminino , Humanos , Injeções Intramusculares , Masculino , Espasticidade Muscular/complicações , Espasticidade Muscular/fisiopatologiaRESUMO
Ten patients with cerebral palsy (CP) were treated with botox (botulinum toxin, type A). The next forms of the disease were observed in the patients: a spastic dysplegia, a spastic hemiplegia, a spastic-hyperkinetic form of CP. Botox was injected into the damaged muscles in a dose of 100-300 Units. Therapeutical effect was found in 90% of the patients, an average duration of the medical effect was 6-12 months. Because of the small cohort of the patients treated with botox there was made a preliminary conclusion about the high efficiency and safety of botox for CP treatment. The need of further clinical observations was emphasized.