[Effectiveness of botulinum toxin in diminishing lower limbs spasticity in children with diplegic form of cerebral palsy].

Abstract

Introduction: Intramuscular injection of botulinum toxine (BTX-A) is important method of spasticity treatment in cerebral palsy (CP) children.

Research and method: Research group consisted of 60 children, aged 2-8 with diagnosed diplegic form of CP treated in years 2002-2004 with BTX-A. Research was conducted before and approximately four weeks and three months after injections. Third examination was performed just before another injection. Patients on the functional level II to IV according to GMFCS were qualified for study. Level of spasticity, range of motion (ROM) and course of rehabilitation were assessed each time. Effectiveness of therapy was also studied based of parent's opinions.

Research outcomes: According to GMFCS 14 children (23.3%) were classified to level II, 29 children (48.4%) to level III and 17 (28.3%) to level IV. In all children spasticity decreased. ROM measured by fast and slow movement in hip, knee and ankle joints increased significantly. During treatment Reimers index was bilaterally normal in 38%, unilaterally in 11% of patients. Index value was normalized in 7.7% of patients. Therapeutic effect of applied treatment method was observed by 96.7% of parents. No side effects have been observed.

Conclusions: By means of BTX-A injections temporary reduction of spasticity in selected muscle groups can be achieved. Injections of BTX-A to hip adductors influence Reimers index helping to prevent norm value. After subsequent injections of BTX-A time period of therapeutic effect changes. Parents of treated children assess BTX-A therapy as highly effective.