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[Botulinum toxin in the management of spasticity in children]
H Benrhouma1, J Yacoubi2, I Kraoua2
1Consultation mouvements anormaux et toxine botulique, Institut National Mongi Ben Hmida, rue Jebbari, La Rabta, 1007 Tunis, Tunisie; Service de neurologie de l'enfant et de l'adolescent, Institut National Mongi Ben Hmida, rue Jebbari, La Rabta, 1007 Tunis, Tunisie.
Insights
This study is the first to describe botulinum toxin (BT) management for spasticity in Tunisian children. Botulinum toxin treatment, combined with physical therapy, significantly improved spasticity symptoms in pediatric patients.
Area of Science:
- Pediatric Neurology
- Rehabilitation Medicine
- Movement Disorders
Background:
- Spasticity is a common motor disorder in children, often impacting quality of life.
- Botulinum toxin (BT) is an established treatment for spasticity.
- Limited data exists on BT use for spasticity in Tunisian pediatric populations.
Purpose of the Study:
- To determine the frequency of spastic children treated with botulinum toxin (BT) in Tunisia.
- To evaluate the efficacy of BT in managing spasticity in Tunisian children.
Main Methods:
- Prospective study conducted over 5 years.
- Inclusion of all spastic children treated with BT at a specialized outpatient clinic.
- Evaluation using the modified Ashworth scale.
Main Results:
- 115 pediatric patients included, representing 31% of clinic attendees.
- Spastic quadriplegia and equinus deformity were common presentations, with cerebral palsy being the most frequent diagnosis.
- Botulinum toxin treatment, often combined with physiotherapy and other interventions, resulted in over 50% average improvement and significantly reduced Ashworth scores.
Conclusions:
- This is the first study detailing botulinum toxin (BT) management for spasticity in Tunisian children.
- BT is a primary treatment for focal spasticity in children.
- Combined BT and physical therapy offers optimal management for spastic children.
Introduction:
Spasticity is a motor disorder, which can be treated by botulinum toxin (BT). We found no studies describing BT management of spasticity in Tunisian children. The aim of our study was to determine the frequency of spastic children treated with BT in the Tunisian hospital population and to evaluate treatment efficacy.
Methods:
We conducted a prospective study over a 5-year period including all children diagnosed with spasticity treated with BT and attending the "Movement Disorders and Botulinum Toxin" outpatient clinic of the National Institute of Neurology of Tunis.
Results:
Hundred and fifteen patients were included (31% of patients attending the "Movement Disorders and Botulinum Toxin" outpatient clinic). Mean age was 7.6years and M:F sex ratio 1.7. Main clinical features were: spastic quadriplegia (48%), equinus deformity (70.4%) and cerebral palsy (88%). All patients were evaluated with the modified Ashworth score and were treated with BT. Other treatments were associated with BT: baclofene, physiotherapy, ortheses, plaster, and sometimes surgical treatment. The average percentage of improvement after BT was>50%. The Ashworth score was significantly lower for the majority of injected muscles.
Discussion And Conclusion:
Our study is the first to describe BT management of spasticity in Tunisian children. Treatments of spasticity are numerous and vary according to location and extent of spasticity. BT is the main treatment for focal spasticity. Associated with physical therapy, BT allows optimal management of spastic children.
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