RESUMO
The medical treatment of spasticity has improved since the introduction of botulinum toxin type A (BTA) for intramuscular injection into spastic muscles. Two not directly comparable preparations are on the market: Botox and Dysport. Botox is four times as potent as Dysport. BTA is especially used for spasticity in legs, arms, and the paravertebral musculature. Surface analgesic cream is applied and an oral or rectal sedative is given after which BTA is injected locally according to strict instructions. In the motor end plate, BTA blocks the release into the synaptic cleft of acetylcholine from vesicles in the terminal nerve fibres, thereby bringing about paralysis of muscle fibre. Blockade lasts for about four months. The treatment must therefore be repeated. Because the treatment is local, side effects are few, mild, and acceptable.
Assuntos
Toxinas Botulínicas Tipo A/administração & dosagem , Espasticidade Muscular/tratamento farmacológico , Toxinas Botulínicas/administração & dosagem , Toxinas Botulínicas Tipo A/efeitos adversos , Criança , Contraindicações , Ensaios Clínicos Controlados como Assunto , Humanos , Placa Motora/efeitos dos fármacos , Transmissão Sináptica/efeitos dos fármacosRESUMO
A girl aged 2.5 years with "covert toxocariasis" was treated with low-dose diethylcarbamazine because of supposed noticeable disseminated Toxocara canis infection without ocular or visceral manifestations. There was marked blood and bone marrow eosinophilia, significant increased Toxocara canis antibody (ELISA) and immunoglobulins E, G and M, leucocytosis and an increased sedimentation rate. She had no geophagia, but often sucked small stones, probably contaminated with faeces from puppies. Symptoms were fever, inactivity, weakness, tiredness and loss of appetite. She was followed clinically and with blood samples throughout a period of three years and four months.
