The efficiency of high dose botulinum toxin type-A in the treatment of cerebral palsy

Abstract

Objective: Cerebral palsy is the most common cause of severe physical disability in childhood. Botulinum toxin type A (BTX-A), has rapidly gained acceptance as a different treatment for spasticity. However, no consensus exists among clinicians about optimal dose of BTX-A in pediatric patients. Doses of 2-6 U/ kg bodyweight with a maximum total dose of 29U/kg have been reported. This study was conducted due to uncertain dosage rage in pediatric use. Method: In this study, 12 patients with cerebral palsy and spastic eqinus foot deformity who referred to our center, were treated with BTX-A in the dosage of 25 U/kg. After treatment of BTX-A, patients were followed up total of 6 months. Three months after treatment, Gross motor functional measurement (GMFM) and Modified Ashwort scale (MAS) were done. At the same time, questionnaires (PCQ) were filled for possible side effects. Results: Average age of 6 girls and 6 boys were 4.5 ± 2.8 years. GMFM and MAS were done before and 3 months after treatment and were found statistically significant (p

Keywords

• Botulinum toxin, cerebral palsy, medical treatment.

Serebral palsi tedavisinde yüksek doz botulinum toksini tip-A tedavisinin etkinliği

Öz

Amaç: Serebral palsi, çocukluk dönemindeki ağır fiziksel yetersizliğin sık görülen sebeplerinden birisidir. Botulinum toksini tip-A (BTX-A), farklı bir tedavi yolu olarak yaygın olarak kabul görmektedir. Bununla beraber, BTX-A\'nın pediatrik optimal dozunun saptanması konusunda, klinisyenler arasında ortak bir konsensus mevcut değildir. Vücut ağırlığı kilogram başına 2-6 Ünitelik dozlardan, maksimum 29 ünite/kg\'lik total doza kadar kullanıldığı bildirilmiştir. Pediatrik kullanım dozu hala kesin olmadığı için bu çalışma yapılmıştır. Yöntemler: Bu çalışmada, rehabilitasyon merkezlerinden sevk edilen serebral palsi (SP) tanılı ve spastik ekinöz deformitesi alan toplam 12 hastaya 25 U/kg BTX-A tedavisi uygulandı. Tedavi sonrası, tüm hastalar toplam 6 ay takip edildi. Tedavinin 3. ayında Gros Motor Fonksiyon Ölçümü (GMFÖ) ve Modifiye Ashwort Skorlaması (MAS) yapıldı. Aynı zamanda, BTX-A tedavi sonrası yan etkiler, çocuk hasta sorgulama formu (ÇHS) ile incelendi. Bulgular: Altı kız ve 6 erkek hastanın yaş ortalaması 4,5 ± 2,8 yıl idi. Tedavi öncesi ve tedavi sonrası 3. ayda yapılan GMFÖ ve MAS skorlaması arasında istatistiksel olarak anlamlı fark bulundu (p

Anahtar Kelimeler

• Botulinum toksini, serebral palsi, medikal tedavi

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