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[Preliminary trial of botulinum toxin A therapy for lower extremity spasticity in children with cerebral palsy]
Atsuo Nezu1, Kazushi Ichikawa, Saoko Takeshita
1Yokohama City University Medical Center, Children's Medical Center, Yokohama, Kanagawa. anezu@urahp.yokohama-cu.ac.jp
Insights
Botulinum toxin A injections significantly improved spasticity and walking in children with cerebral palsy. This safe treatment also enhanced brace tolerance and caregiver assistance, with no observed side effects.
Area of Science:
- Neurology
- Pediatrics
- Rehabilitation Medicine
Context:
- Cerebral palsy (CP) often causes gait disturbance and spasticity in children.
- Current management strategies may have limitations in addressing these symptoms effectively.
- Botulinum toxin A (BTA) is a potential therapeutic agent for managing pediatric spasticity.
Purpose:
- To evaluate the safety and efficacy of Botulinum toxin A (BTA) injections for improving gait disturbance and spasticity in children with cerebral palsy (CP).
Summary:
- Eleven children diagnosed with cerebral palsy and experiencing gait issues (mean age 5.6 years) received BTA injections in key leg muscles.
- A significant improvement in spasticity and gait disturbance was observed in all participants four weeks post-treatment.
- Parents reported enhanced brace tolerance and reduced need for caregiver assistance, with no adverse events noted.
Impact:
- BTA treatment demonstrates a safe and effective approach for managing leg spasticity in pediatric cerebral palsy.
- The findings support the consideration of BTA for clinical use in improving mobility and quality of life for children with CP.
- This study recommends approval for BTA use in Japan for managing spasticity in pediatric cerebral palsy patients.
Abstract:
Eleven children with gait disturbance due to cerebral palsy (mean age, 5.6 years, ranging from 2.4 to 11.5) were treated with Botulinum toxin A (BTA, BOTOX, Allergan) for improvement of spasticity and walking difficulty. BTA was injected into the gastrocnemius, adductors, and hamstring muscles with an initial total dose up to 8 units/kg or 100 units. Spasticity and gait disturbance were significantly improved in all patients 4 weeks after the treatment. Their parents also reported that BTA was helpful for brace tolerance and assistance of caregivers. No side effects including worsening of gait or signs of systemic adverse effects were observed. Management of leg spasticity with BTA is thought to be useful and safe, and approval for this use in Japan is recommended.
