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