Management of spasticity and dystonia in children with acquired brain injury with rehabilitation and botulinum toxin A.

The purpose of this study was to investigate the effect of a combination of botulinum toxin A (BTX-A) and rehabilitation on spasticity, pain and motor functioning in children with acquired brain injury (ABI).  All children and adolescents with ABI, aged 2-20 years, consecutively treated in the department over a 22-month period, were prospectively followed-up and clinically assessed pre- and post-treatment. They had spasticity and/or dystonia leading to impairment in activities of daily living, orthopaedic deformations and/or pain. Injections were performed using electro-stimulation. Doses of BTX-A (Botox) were administered using recent recommendations. All patients received BTX-A injections, followed with physical and/or occupational therapy. Significant improvement was achieved for spasticity reduction, command on antagonist muscles and goniometry assessment. Pain relief was achieved in patients in a minimally responsive state. Functional goals were achieved, such as improving transfers or gait, grasping and releasing abilities, with significant transfer in activities of daily living.

A combination of BTX-A injection with rehabilitation is an interesting option for treatment of muscle tone disorders in children with ABI.

Guettard E, Roze E, Abada G, Lemesle C, Vidailhet M, Laurent-Vannier A, Chevignard MP. Management of spasticity and dystonia in children with acquired brain injury with rehabilitation and botulinum toxin A. Dev Neurorehabil. 2009 Jun;12(3):128-38

Related posts:

1. A randomized controlled trial to compare two botulinum toxin injection techniques on the functional improvement of the leg of children with cerebral palsy.
2. A randomized controlled trial to compare two botulinum toxin injection techniques on the functional improvement of the leg of children with cerebral palsy
3. Physiotherapy does not prevent, or hasten recovery from, ventilator-associated pneumonia in patients with acquired brain injury
4. The effect of injections of botulinum toxin type A combined with casting on the equinus gait of children with cerebral palsy
5. Does low-dose botulinum toxin help the recovery of arm function when given early after stroke? A phase II randomized controlled pilot study to estimate effect size.