Bocca PG, Iglesias BA, Rodríguez AME

Language: Spanish
References: 17
Page: 46-50
PDF size: 168.89 Kb.

ABSTRACT

Botulinum toxin type A, has been widely used for more than 20 years; an option in the treatment of spasticity in Cerebral Palsy, after adequate assessment, seeks to limit the progression of orthopedic problems, fixed contractures and dilate the need of a surgery, in order to improve its functionality, quality of life of the child and also of those who take care of them, the medical literature documents that the effect usually lasts until the third or fourth month after its application, the purpose of this study is to evaluate the variability of the effect of botulinum toxin type A (BTA) in the different stages of spasticity. Material and methods: Experimental study, longitudinal clinical trial type, without control group, carried out in a universe of 235 patients, between 1 and 17 years old, with diagnosis of spastic cerebral palsy, submitted to a single infiltration procedure of multilevel TBA according to the previous clinical examination, and as the main outcome measure was the Ashworth Modified Scale, at the first, third and sixth months. Results: Significant effect of TBA was observed in spasticity, in the first control (p 0.002) and second control (p 0.017); at the sixth month of follow-up 68.84% of patients returned to the stage before the application compared to 31.36% who retained the effect of the medication. Conclusion: The findings show variability in the duration of the effect of the BTA, existing inverse relationship to greater level of spasticity, important point to decide a new application, here the importance of the individualized evaluation of the objectives set as integrative treatment.

REFERENCES

1. Fejerman N, Arroyo H. Trastornos motores crónicos en niños y adolescentes. Argentina: Panamericana; 978-950-06-0307-2, Editorial Medica Panamericana, S.A. 2013, p. 464.

2. Navarrete A, Peters D, Ruz S. Resultado funcional de infiltración de toxina botulínica multinivel en extremidades inferiores y terapia integral en niños con parálisis cerebral espástica. Rehabilitación. 2010; 44(3): 236-243.

3. Jover-Martínez E, Ríos-Díaz J, Poveda-Pagán EJ. Relación entre escalas de espasticidad y escalas de independencia y estado funcional en pacientes con parálisis cerebral. Fisioterapia. 2015; 37(4): 175-184.

4. Lillo S, Haro M. Usos prácticos de la toxina botulínica en niños y adolescentes en medicina física y rehabilitación. Revista Médica Clínica Las Condes. 2014; 25(2): 209-223.

5. Placzek R, Siebold D, Funk JF. Development of treatment concepts for the use of toxin A botulinum in children with cerebral palsy. Toxins (Basel). 2010; 2(9): 2258-2271.

6. Berumen AE, Zorrilla SJ, Valdes CC, Pérez MJ, Mendoza ML, Philippe M y cols. Consenso Nacional del Sistema de Centros de Rehabilitación Infantil Teletón (SCRIT) México en el uso de la toxina botulínica tipo A para el manejo de espaticidad y otras alteraciones neuromusculoesqueléticas en niños. Rev Mex Med Fis Rehab. 2014; 26(2): 45-65.

7. Alarcón MM, Arroyo RM, Burget GS. Rehabilitación infantil. Madrid: Panamericana; 2012.

8. Koman LA, Mooney JF 3rd, Smith BP, Walker F, Leon JM. Botulinum toxin type A neuromuscular blockade in the treatment of lower extremity spasticity in cerebral palsy: a randomized, double-blind, placebo-controlled trial. BOTOX Study Group. J Pediatr Orthop. 2000; 20(1): 108-115.

9. Heinen F, Desloovere K, Schroeder AS, Berweck S, Borggraefe I, van Campenhout A et al. The updated European Consensus 2009 on the use of Botulinum toxin for children with cerebral palsy. Eur J Paediatr Neurol. 2010; 14(1): 45-66.

10. Lin YC, Huang C, Lin I, Shieh J, Chung Y, Chen K. Evaluating functional outcomes of botulinum toxin type a injection combined with occupational therapy in the upper limbs of children with cerebral palsy: a 9-month follow-up from the perspectives of both child and caregiver. PlosOne. 2015; 10(11): e0142769.

11. Tilton A, Russman B, Aydin R, Dincer U, Escobar R, Kutlay S et al. Abobotulinumtoxin A (Dysport®) improves function according to goal attainment in children with dynamic equinus due to cerebral palsy. Journal of Child Neurology. 2017; 32(5): 482-487.

12. Desloovere K, Schörkhuber V, Fagard K, Van Campenhout A, De Cat J, Pauwels P. Botulinum toxin type A in the treatment of children with cerebral palsy: evaluation of success or failure of treatment through the achievement of objectives of scales. European Journal of Pediatric Neurology. 2012; 16(3): 229-236.

13. Chana Cuevas P, Benavides O, Gonzales P, Aguilera C, Arigon E, Canals MF, et al. Consenso Chileno del uso de toxina botulínica (500u) en Neurología y Fisiatría. Consenso. Santiago de Chile: Universidad Santiago de Chile, Centro de trastornos del Movimiento; 2012.

14. Bar-On L, Van Campenhout A, Desloovere K, Aertbeliën E, Huenaerts C, Vandendoorent B et al. Is an instrumented spasticity assessment an improvement over clinical spasticity scales in assessing and predicting the response to integrated botulinum toxin type a treatment in children with cerebral palsy? Arch Phys Med Rehabil. 2014; 95(3): 515-523.

15. García BC, Venta SJ, Hernández SJ, Navarro VL. Espasticidad en niños. Revista Mexicana de Neurociencia. 2009; 10(2): 107-111.

16. García-Sánchez SF, Gómez-Galindo MA, Guzmán-Pantoja JE. Toxina botulínica A y terapia física, en la marcha en parálisis cerebral. Rev Med Inst Mex Seguro Soc. 2017; 55(1): 18-24.

17. Camargo CH, Teive HA, Zonta M, Silva GC, Oliveira Mr, Roriz MM et al. Botulinum toxin type A in the treatment of lower-limb spasticity in children with cerebral palsy. Arq. Neuro-Psiquiat. 2009; 67(1)_ 62-68.