P-2-10-04
THE EFFECT OF BOTULINUM TOXIN IN THE TREATMENT OF SPASTICITY IN CEREBRAL PALSY
Y. Watanabe-1,2, AMO Bakheeit-1 and DL McLellan-1 (1. Southampton General Hospital, Southampton, UK, 2. Saga Medical School, Saga, Japan)
Muscle spasticity is a common cause of severe functional disability in children with cerebral palsy (CP). It often leads to muscle contractures and interferes with safe and energy-efficient walking. Longterm treatment with antispasticity drugs is usually ineffective and is often associated with cognitive and other adverse effects. Similarly, chemical neurolysis with alcohol or phenol nerve blocks may cause unacceptable morbidity, is time-consuming and requires special equipment and expertise. Nerve blocks are also less effective when repeated more than twice.
Botulinum toxin type A (BTXA) has been shown to be effective and safe in the treatment of dystonias. Recently, its effectiveness has been demonstrated in spastic mice and preliminary evidence suggests that it might also be useful the management of muscle spasticity in children and adults. However, the published data is inconclusive because of the small number of patients studied, the inappropriateness of the outcome measures used and the open-label nature of these studies.
The purpose of the present study is to evaluate the effectiveness of BTXA in the treatment of muscle spasficity in children with CP using a prospective study design. Outcome was measured by the modified Ashworth Scale and laboratory gait analysis. Preliminary evidence suggested that BTXA improved motor function in these patients.
P-2-10-05
THE EFFECTIVENESS OF SELECTIVE POSTERIOR RHIZOTOMY FOR THE REHABILITATION IN CHILDREN WITH CEREBRAL PALSY
Jae-Wook Ryu, Kay-Ho Chun, Bong-Ok Kim (Chungnam National University, Taejon, Korea)
Selective posterior rhizotomy (SPR) is a neurosurgical procedure designed to alleviate spasticity and has been successfully used for children with spastic cerebral palsy.
We evaluated eleven children who had follow up over 6 months after SPR. The authors have analyzed the status of the children with spastic cerebral palsy before and after operation to determine the effects of this therapy on muscle tone, functional grade, gross motor function and gait pattern. Gross motor function was measured by gross motor function measure (GMFM) scale.
The results showed that SPR combined with intensive postoperative rehabilitation for children with spastic cerebral palsy had a significant positive effect on gross motor function
