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[Botulinum toxin a treatment in spastic forms of cerebral palsy: a retrospective clinical study]
A Fujak1, S Köckeritz, L Häberle
1Orthopädische Universitätsklinik, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen. a.fujak@t-online.de
Insights
Botulinum toxin (BTX) therapy is effective for children with spastic cerebral palsy. Patients with less severe hemiparesis or diparesis reported greater benefits and satisfaction compared to those with tetraparesis.
Area of Science:
- Neurology
- Pediatrics
- Rehabilitation Medicine
Context:
- Botulinum toxin (BTX) therapy is established for managing spastic cerebral palsy in pediatric patients.
- Evaluating patient and family subjective satisfaction is crucial for treatment efficacy.
- Understanding treatment outcomes requires differentiating patient groups based on spasticity severity.
Purpose:
- To assess subjective and practical outcomes of botulinum toxin A infiltrations in children with infantile spastic cerebral palsy.
- To compare treatment satisfaction and perceived success between patients with spastic hemiparesis/diparesis and tetraparesis.
- To document infiltration data under anesthesia for pediatric cerebral palsy patients.
Summary:
- A study involving 57 children with spastic cerebral palsy (mean age 11) evaluated 118 botulinum toxin A infiltrations.
- Patients were grouped into spastic hemiparesis/diparesis and tetraparesis for comparative analysis.
- Results indicated higher perceived benefits and expectation fulfillment in the less affected group (hemiparesis/diparesis).
Impact:
- Botulinum toxin therapy is perceived as effective and acceptable by patients and families for spastic cerebral palsy.
- Realistic goal setting and detailed discussion with patients/families are vital, especially for severe tetraparesis cases.
- This research informs clinical practice regarding patient selection and expectation management in pediatric BTX therapy.
Background:
Botulinum toxin therapy now has a firm place in the treatment of spastic forms of cerebral palsy in children. This paper considers the subjective and practical results and the degrees of satisfaction from the point of view of the patients and their families. It also documents the data of infiltrations carried out under anaesthesia.
Patients And Methods:
57 patients with an average age of 11 (± 6.7; 2-30) and with infantile spastic cerebral palsy underwent altogether 118 botulinum toxin A infiltrations. The patients were divided into two groups: those with spastic hemiparesis or diparesis, and those with tetraparesis, and then compared with each other. The results of the treatment were evaluated from the point of view of the patients and their families with the help of a specially developed questionnaire.
Results:
The study shows that, broadly-speaking, patients less affected with spastic hemiparesis or diparesis felt they profited more from the treatment than patients more severely affected with tetraparesis. The statistics also show that the first group's expectations were significantly more often fulfilled and that they more frequently perceived greater success after each infiltration than the group with tetraparesis. Most patients and their families from both groups were satisfied with the treatment.
Conclusion:
Patients and their families feel that the use of botulinum toxin in the management of spastic cerebral palsy in children is an effective and accepted form of treatment. The aims of the therapy should be defined accurately and realistically before starting treatment, especially for those severely affected with tetraparesis, and discussed in detail with both the patient and his/her family.
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