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Botulinum Toxin Type A for Pediatric Torticollis: A Review of Clinical Research
Na-Yoen Kwon1, Soo-Hyun Sung2, Hyun-Kyung Sung3
1Department of Obstetrics and Gynecology, College of Korean Medicine, Ga-Chon University, Seongnam-si 13120, Republic of Korea.
Insights
Botulinum toxin type A (BoNT-A) offers a safe and effective treatment for pediatric torticollis unresponsive to conventional therapies. This minimally invasive option improves head posture and cervical mobility, enhancing patient outcomes.
Area of Science:
- Pediatric Neurology
- Musculoskeletal Disorders
- Pharmacology
Background:
- Pediatric torticollis, often congenital muscular torticollis, involves sternocleidomastoid muscle shortening, causing head tilt and limited neck movement.
- While physical therapy is standard, some infants have persistent symptoms requiring alternative treatments.
- Botulinum toxin type A (BoNT-A) is a minimally invasive option targeting muscle hypertonicity.
Purpose of the Study:
- To review the efficacy and safety of botulinum toxin type A (BoNT-A) for pediatric torticollis.
- To synthesize evidence from randomized controlled trials and case reports on BoNT-A's use in this condition.
Main Methods:
- A scoping review of six studies was conducted.
- Included studies assessed BoNT-A's impact on range of motion, head posture, and patient satisfaction.
- Safety data, including adverse events, were also analyzed.
Main Results:
- BoNT-A consistently improved cervical range of motion and head posture.
- Patient satisfaction was notably enhanced with BoNT-A treatment.
- Adverse events were rare and mild, primarily local bruising and temporary muscle weakness.
Conclusions:
- Botulinum toxin type A (BoNT-A) is a valuable therapeutic option for pediatric torticollis refractory to conservative management.
- Standardized treatment guidelines and further research are needed due to variability in current protocols.
- Integration into multidisciplinary care frameworks is recommended for optimal patient outcomes.
Abstract:
Pediatric torticollis, predominantly resulting from congenital muscular torticollis, is characterized by unilateral shortening of the sternocleidomastoid muscle, leading to head tilt and limited cervical mobility. Conventional management primarily involves physical therapy and repositioning strategies, with most infants achieving full recovery. However, a subset of patients exhibits persistent symptoms despite conservative treatment. Botulinum toxin type A (BoNT-A) has emerged as a minimally invasive adjunct intervention that targets muscular hypertonicity by inhibiting acetylcholine release at neuromuscular junctions. This scoping review synthesizes clinical evidence from six studies, including randomized controlled trials and case reports, assessing the efficacy and safety of BoNT-A in pediatric torticollis. Results indicate consistent improvements in range of motion, head posture correction, and patient satisfaction, with rare and mild adverse events such as local bruising and transient muscle weakness. Despite promising outcomes, variability in dosing, injection protocols, and follow-up durations underscores the need for standardized treatment guidelines and further high-quality research. These findings support BoNT-A as a valuable therapeutic option for refractory pediatric torticollis, warranting integration into multidisciplinary care frameworks.
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