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Botulinum toxin injections for pediatric patients with hereditary spastic paraparesis

Keren Geva-Dayan1, Dafna Domenievitz, Rafat Zahalka

  • 1Pediatric Neurology Unit, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Journal of Child Neurology
|April 22, 2010
PubMed

Insights

Botulinum toxin type A injections improved muscle tone and motor function in children with hereditary spastic paraplegia. This treatment offers prolonged functional benefits for pediatric patients with this progressive neurological disorder.

Area of Science:

  • Neurology
  • Pediatrics
  • Rehabilitation Medicine

Background:

  • Hereditary spastic paraplegia (HSP) is a group of inherited neurological disorders characterized by progressive weakness and spasticity in the lower limbs.
  • Limited data exists on the efficacy of botulinum toxin type A (BoNT-A) injections for managing HSP symptoms in pediatric populations.

Purpose of the Study:

  • To evaluate the effectiveness of botulinum toxin type A injections in improving muscle tone and motor function in children diagnosed with hereditary spastic paraplegia.

Main Methods:

  • A cohort of 12 pediatric patients with HSP (mean age 4.8 years) received 1 to 6 sessions of BoNT-A injections targeting the hamstrings, adductors, and gastrocnemius muscles.
  • Muscle tone was assessed using the Ashworth Scale, and motor function was evaluated with the Gross Motor Function Measure (GMFM).
  • Outcomes were tracked over a mean study period of 2.8 years, with a mean follow-up duration of 6.6 months post-injection.

Main Results:

  • BoNT-A injections significantly reduced muscle tone (Ashworth Scale: 1.9 to 1.18, P < .001) and improved motor function (GMFM: 75.3 to 77.7, P < .001).
  • The positive effects on muscle tone and motor function persisted for a mean of 6.6 months.
  • Over the study period, the baseline GMFM scores showed a significant increase (69.2 to 78.3, P = .005), indicating sustained functional gains.

Conclusions:

  • Botulinum toxin type A injections are a safe and effective treatment for improving lower limb muscle tone and motor function in pediatric patients with hereditary spastic paraplegia.
  • The treatment provides prolonged functional benefits, which is significant given the progressive nature of HSP.
  • BoNT-A injections represent a valuable therapeutic option for enhancing the quality of life and functional independence in children with HSP.

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