[Multilevel botulinum toxin treatment in severe spastic forms of cerebral palsy (GMFCS IV-V)].

Autor:	Kurenkov AL; National Medical Research Center for Children's Health, Moscow, Russia., Klochkova OA; National Medical Research Center for Children's Health, Moscow, Russia., Kuzenkova LM; National Medical Research Center for Children's Health, Moscow, Russia., Bursagova BI; National Medical Research Center for Children's Health, Moscow, Russia., Karimova KM; National Medical Research Center for Children's Health, Moscow, Russia.
Jazyk:	ruština
Zdroj:	Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova [Zh Nevrol Psikhiatr Im S S Korsakova] 2020; Vol. 120 (12), pp. 57-66.
DOI:	10.17116/jnevro202012012157
Abstrakt:	Objective: To evaluate the most typical target muscles and dosages for the first and repeated botulinum toxin A (BTA) injections in cerebral palsy (CP) patients with severe motor deficit - GMFCS IV-V. Material and Methods: A retrospective analysis of 677 protocols of the first and repeated Abobotulinumtoxin A (AboA) injections in 333 patients with CP GMFCS IV and V, aged 1 to 18 years, was carried out. Results: Ninety-seven percent of patients received multilevel injections. In the lower extremities the most typical target muscles were: m.gracilis - 221 (66.4%) patients, hip adductors - 164 (49.2%), medial hamstring - 144 (43.2%). In the upper extremities the most typical muscles were: m.pronator teres - 237 (71.2%) patients, m.biceps brachii+m.brachialis - 197 (59.2%). The total dosages of AboA and dosages for every target muscle were calculated. Several patients required high dosages (more than 30 U/kg of AboA). Higher dosages per kg were used in younger children and for repeated injections. The age-related evolution of spastic patterns was described. Adverse events were observed in 36 cases (5.3% of all injections). Conclusion: The majority of patients with GMFCS IV-V required multilevel BTA injections in high dosages, especially in young age. Described selection of target muscles and dosages of AboA could be taken into account as a practical experience and reference for the BTA therapy in GMFCS IV-V patients.
Databáze:	MEDLINE
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