MANAGEMENT OF CEREBRAL-PALSY WITH BOTULINUM-A TOXIN - PRELIMINARY INVESTIGATION
MANAGEMENT OF CEREBRAL-PALSY WITH BOTULINUM-A TOXIN - PRELIMINARY INVESTIGATION
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DOI：
10.1097/01241398-199307000-00013
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发表时间：
1993-07-01
影响因子：
1.7
通讯作者：
MULVANEY, T
中科院分区：
文献类型：
--
作者：
KOMAN, LA;MOONEY, JF;MULVANEY, T
使用肌肉注射A型肉毒杆菌毒素(肉毒杆菌毒素)产生神经肌肉阻断已经在治疗某些眼和面部肌肉失衡以及痉挛性斜颈方面有效。在这项初步的开放性研究中，对27名儿童患者肌肉内注射肉毒杆菌毒素治疗脑性瘫痪肌肉失衡的效果进行了评估。每个患者都有“动态畸形”，对其他治疗没有反应，手术是唯一现实的选择。肉毒杆菌的剂量是以单位/体重为单位计算的。在非卧床患者中，临床步态变化通过医生评分表进行评估。痉挛程度在注射后12~72h明显减少，达到目标阈值后，肉毒杆菌毒素的作用持续3~6个月。未发生重大副作用。肉毒杆菌毒素在脑性瘫痪痉挛的保守治疗中可能被证明是一种有用的辅助手段。这些注射的成功处理可能会使手术干预推迟到孩子长大，并降低可能发生并发症的风险，包括需要重复手术程序。
Use of intramuscular botulinum-A toxin (Botox) to produce neuromuscular blockade has been effective in treating certain ocular and facial muscular imbalances as well as spasmodic torticollis. In this preliminary open study, the effectiveness of intramuscularly injected Botox on the muscular imbalances of cerebral palsy was assessed in 27 pediatric patients. Each patient had ''dynamic deformities'' unresponsive to other treatment, and operation was the only other realistic alternative. The dose of Botox was calculated on a unit/body weight basis. In ambulatory patients, clinical changes in gait were assessed by a physician's rating scale. Reduction in spasticity became apparent in 12-72 h after injection; the effect of Botox after target threshold was reached lasted 3-6 months. No major side effects occurred. Botox may prove a useful adjuvant in conservative management of the spasticity of cerebral palsy. Successful management with these injections may allow delay of surgical intervention until the child is older and at less risk of possible complications, including the need for repeated surgical procedures.