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Use of botulinum toxin injection in 17 children with spastic cerebral palsy
1Department of Paediatrics; The University of Hong Kong; Queen Mary Hospital; Hong Kong Special Administrative Region, People's Republic of China.
Insights
Botulinum toxin injections effectively reduced spasticity and improved function in children with cerebral palsy. This safe adjunctive therapy showed lasting benefits, enhancing mobility and daily activities.
Area of Science:
- Pediatric Neurology
- Rehabilitation Medicine
- Pharmacology
Background:
- Spastic cerebral palsy significantly impacts children's motor function and quality of life.
- Current therapeutic options for spasticity management in children are limited.
- Botulinum toxin has shown promise in adult spasticity but requires further investigation in pediatric populations.
Purpose of the Study:
- To evaluate the efficacy and tolerability of botulinum toxin as an adjunctive therapy for spasticity in children with cerebral palsy.
- To assess the impact of botulinum toxin on functional status, range of motion, and motor performance.
- To determine the duration and safety profile of botulinum toxin treatment in this cohort.
Main Methods:
- A prospective study involving 17 children (11 ambulatory, 6 nonambulatory) with spastic cerebral palsy.
- All participants received botulinum toxin injections as an adjunct to an ongoing physiotherapy program.
- Baseline assessments included spasticity scores, functional status, joint range of motion, and video analysis, with follow-up for up to 10 months.
Main Results:
- Botulinum toxin demonstrated rapid onset of action (within 72 hours) with peak effects at 1-2 weeks, lasting 3-10 months.
- Significant reductions in spasticity scores were observed in all children.
- Functional improvements included enhanced ambulation (three nonambulatory children became ambulatory with assistance, five with assisted ambulation improved independence), improved range of motion, and better performance in sit-to-stand and standing tasks.
Conclusions:
- Botulinum toxin is a safe and effective adjunctive therapy for ameliorating spasticity in children with cerebral palsy.
- The treatment leads to significant improvements in motor function, range of motion, and functional independence.
- Botulinum toxin is particularly beneficial for younger children with cerebral palsy, offering a valuable therapeutic option.
Abstract:
The use of botulinum toxin was studied in 17 children with spastic cerebral palsy to determine its efficacy and tolerability. Eleven ambulatory and 6 nonambulatory patients were included. All children were undergoing a physiotherapy program with monitoring of their baseline states for 3 months before botulinum toxin injection. The effect was evident within 72 hours. The peak effect was noticed by 1 to 2 weeks in the majority; the effect lasted for 3 to 10 months. All children experienced decreased spasticity scores. Their functional status improved, with three nonambulatory children becoming ambulatory with assistance and five children with assisted ambulation becoming more independently ambulatory. Measurement of joint motion showed improvement in the range of motion as compared with baseline. Video analysis of the functional state in the nonambulatory or gait in the ambulatory children revealed improvement in all. The functional status of rising from the sitting position or standing demonstrated improvement. None of the children had any untoward side effects except mild transient pain at the injection site. This study demonstrated botulinum toxin is useful as an adjunctive therapy in ameliorating spasticity in children with cerebral palsy, especially in the younger ones.