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Cerebral palsy toxin

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https://www.readbyqxmd.com/read/28634003/spasticity-video-challenge-a-look-at-methods-for-addressing-difficult-cases
#1
Katharine E Alter, Mark Gormley, Atul T Patel
As seen in this CME online activity (available at http://courses.elseviercme.com/spasticity/662e), treatment of patients with spasticity due to upper motor neuron syndromes, including traumatic brain injury, stroke, and cerebral palsy, is multifaceted, involving chemodenervation, systemic medications, surgical therapy, rehabilitation efforts, and home care. Optimal care begins with the recognition that each patient's impairments are unique and must be assessed carefully to determine the impact of muscle overactivity, loss of dexterity, and weakness on passive and active function in the context of the patients' goals...
June 19, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/28623614/abobotulinumtoxina-a-review-in-pediatric-lower-limb-spasticity
#2
Yahiya Y Syed
AbobotulinumtoxinA (Dysport(®)) is currently the only botulinum toxin A formulation approved by the US FDA for the treatment of lower limb spasticity in pediatric patients aged ≥2 years. Intramuscular abobotulinumtoxinA was approved based on the results of a pivotal phase 3 trial in children with lower limb spasticity due to cerebral palsy. In this trial, a single treatment cycle with abobotulinumtoxinA 10-15 U/kg/leg injected into the gastrocnemius and soleus muscles significantly improved ankle plantar flexor muscle tone (primary endpoint), with abobotulinumtoxinA recipients showing a significant response to treatment relative to placebo...
June 16, 2017: Paediatric Drugs
https://www.readbyqxmd.com/read/28604409/posture-dependent-dysphagia-after-botulinum-toxin-type-a-injection-at-sternocleidomastoid-in-a-patient-with-athetoid-cerebral-palsy
#3
Won Kee Chang, Keewon Kim, Han Gil Seo, Ja-Ho Leigh, Moon Suk Bang
Cervical dystonia is a common issue in patients with athetoid cerebral palsy. Botulinum toxin injection to dystonic cervical muscles is a well-recognized treatment option, but it is known to be associated with dysphagia. Previously reported cases of dysphagia after botulinum toxin injection to the sternocleidomastoid muscle were related to the regional spread of toxin to the pharyngeal muscles. We report a unique case of posture-dependent dysphagia due to preactivation of the suprahyoid and infrahyoid muscles to compensate for impaired head stabilization by the weakened sternocleidomastoid muscle while swallowing...
June 9, 2017: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/28582880/the-effect-of-botulinum-toxin-a-botox-injections-used-to-treat-limb-spasticity-on-speech-patterns-in-children-with-dysarthria-and-cerebral-palsy-a-report-of-two-cases
#4
Marilyn Seif Workinger, Raymond D Kent, Jill R Meilahn
Botulinum toxin A (Btx-A) injections are used to treat limb spasticity in children with cerebral palsy (CP) resulting in improved gross and fine motor control. This treatment has also been reported to have additional functional effects, but the effect of treatment on speech has not been reported. This report presents results of longitudinal speech evaluation of two children with CP given injections of Btx-A for treatment of limb spasticity. Speech evaluations were accomplished at baseline (date of injections) and 4- and 10-weeks post-injections...
May 19, 2017: Journal of Pediatric Rehabilitation Medicine
https://www.readbyqxmd.com/read/28520679/knee-recurvatum-in-children-with-spastic-diplegic-cerebral-palsy
#5
Jeremy Bauer, K Patrick Do, Jing Feng, Rosemary Pierce, Michael Aiona
BACKGROUND: The purpose of this study is to determine which factors drive patients with diplegic cerebral palsy to walk without knee recurvatum despite hyperextension of the knee on physical examination. METHODS: A retrospective review was conducted of all data collected in the Gait Analysis Laboratory between 1999 and 2014. Patients with spastic diplegic cerebral palsy and at least 5 degrees of knee extension on clinical examination were identified for the study...
May 17, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28497442/-myths-and-evidence-on-the-use-of-botulinum-toxin-spasticity-in-adults-and-in-children-with-cerebral-palsy
#6
J C Martinez-Castrillo, J L Pena-Segura, P Sanz-Cartagena, X Alonso-Curco, J M Arbelo-Gonzalez, G Arriola-Pereda, M D Coll-Bosch, J A Conejero-Casares, A Garcia-Ribes, S Jauma-Classen, J Pagonabarraga, J Vidal-Valls, P J Garcia-Ruiz
INTRODUCTION: Spasticity is a medical problem with a high incidence that significantly impact on the quality of life of patients and their families. AIM: To analyze and to answer different questions about the use of botulinum toxin type A (BTA) in our clinical practice. DEVELOPMENT: A group of experts in neurology develop a list of topics related with the use of BTA. Two big groups were considered: spasticity in adults and in children with cerebral palsy...
May 16, 2017: Revista de Neurologia
https://www.readbyqxmd.com/read/28414728/clown-care-reduces-pain-in-children-with-cerebral-palsy-undergoing-recurrent-botulinum-toxin-injections-a-quasi-randomized-controlled-crossover-study
#7
RANDOMIZED CONTROLLED TRIAL
Hilla Ben-Pazi, Avraham Cohen, Naama Kroyzer, Renana Lotem-Ophir, Yaakov Shvili, Gidon Winter, Lisa Deutsch, Yehuda Pollak
OBJECTIVE: We investigated the impact of clown-care on pain in 45 children with cerebral palsy who underwent recurrent Botulinum-toxin injections (age 7.04± 4.68 years). Participants were randomized to receive either clown (n = 20) or standard (n = 25) -care. METHODS: Pain Visual-Analogue-Scale (range 1-5) was reported before and after procedures. Pain assessment was lower for children undergoing Botulinum-toxin injections with clown-care (2.89± 1.36) compared to standard-care (3...
2017: PloS One
https://www.readbyqxmd.com/read/28393669/serial-casting-as-an-adjunct-to-botulinum-toxin-type-a-treatment-in-children-with-cerebral-palsy-and-spastic-paraparesis-with-scissoring-of-the-lower-extremities
#8
Alper I Dai, Abdullah T Demiryürek
The purpose of this study was to examine whether combination therapy of serial casting and botulinum toxin type A injection can further enhance the effects of botulinum toxin type A in children with cerebral palsy with scissoring of both legs. This study was a prospective and randomized trial. The children were divided into 2 groups, one of which received serial casting after botulinum toxin type A (n = 40), and the other which only received botulinum toxin type A (n = 40). Serial casting started 3 weeks after the botulinum toxin type A...
January 1, 2017: Journal of Child Neurology
https://www.readbyqxmd.com/read/28385185/antibody-responses-to-botulinum-neurotoxin-type-a-of-toxin-treated-spastic-equinus-children-with-cerebral-palsy-a-randomized-clinical-trial-comparing-two-injection-schedules
#9
Minako Oshima, Philip Deitiker, Tandy Hastings-Ison, K Roger Aoki, H Kerr Graham, M Zouhair Atassi
We have conducted a 26-month-long comparative study involving young patients (2-6years old) with a clinical diagnosis of spastic equinus secondary to cerebral palsy who have been treated with BoNT/A (BOTOX®, Allergan) tri-annually or annually. Serum samples were obtained to determine the presence or absence of blocking antibodies (Abs) by a mouse protection assay (MPA) and levels of anti-BoNT/A Abs by radioimmune assay (RIA). HLA DQ alleles were typed using blood samples to determine the possible association of certain HLA type(s) with the disease or with the Ab status...
May 15, 2017: Journal of Neuroimmunology
https://www.readbyqxmd.com/read/28279852/effectiveness-of-surgical-and-non-surgical-management-of-crouch-gait-in-cerebral-palsy-a-systematic-review
#10
REVIEW
Scott A Galey, Zachary F Lerner, Thomas C Bulea, Seymour Zimbler, Diane L Damiano
BACKGROUND: Cerebral palsy (CP) is a prevalent group of neuromotor disorders caused by early injury to brain regions or pathways that control movement. Patients with CP exhibit a range of functional motor disabilities and pathologic gait patterns. Crouch gait, characterized by increased knee flexion throughout stance, is a common gait pattern in CP that increases energy costs of walking and contributes to ambulatory decline. Our aim was to perform the first systematic literature review on the effectiveness of interventions utilized to ameliorate crouch gait in CP...
February 24, 2017: Gait & Posture
https://www.readbyqxmd.com/read/28271231/quantitative-assessment-of-muscle-stiffness-with-acoustic-radiation-force-impulse-elastography-after-botulinum-toxin-a-injection-in-children-with-cerebral-palsy
#11
Meltem Ceyhan Bilgici, Tumay Bekci, Yasemin Ulus, Ayhan Bilgici, Leman Tomak, Mustafa Bekir Selcuk
PURPOSE: Our objective in this study was to assess the changes in medial gastrocnemius muscle (GCM) stiffness after botulinum toxin A (BTA) injection in children with cerebral palsy (CP) by using acoustic radiation force impulse (ARFI) elastography and to research the usability of this technique in clinical practice. MATERIALS AND METHODS: Twenty-four spastic lower extremities of 12 children with CP were assessed. BTA injection treatment was applied to the medial GCM...
March 7, 2017: Journal of Medical Ultrasonics
https://www.readbyqxmd.com/read/28187305/improvement-of-upper-trunk-posture-during-walking-in-hemiplegic-patients-after-injections-of-botulinum-toxin-into-the-arm
#12
Harald Hefter, Dietmar Rosenthal
BACKGROUND: It has been hypothesized that altered trunk movements during gait in post-stroke patients or children with cerebral palsy are compensatory to lower limb impairment. Improvement of trunk movements and posture after injections of botulinum toxin into the affected arm would be at variance with this hypothesis and hint towards a multifactorial trunk control deficit. PATIENTS AND METHODS: Clinical gait analysis was performed in 11 consecutively recruited hemiplegic patients immediately before and 4weeks after a botulinum toxin type A-injection into the affected arm...
January 26, 2017: Clinical Biomechanics
https://www.readbyqxmd.com/read/28166806/the-we-study-does-botulinum-toxin-a-make-walking-easier-in-children-with-cerebral-palsy-study-protocol-for-a-randomized-controlled-trial
#13
Siri Merete Brændvik, Karin Roeleveld, Guro Lillemoen Andersen, Anne Elisabeth Ross Raftemo, Kjersti Ramstad, Jasmina Majkic-Tajsic, Torarin Lamvik, Bendik Lund, Turid Follestad, Torstein Vik
BACKGROUND: Intramuscular injections of botulinum toxin A (BoNT-A) have been a cornerstone in the treatment of spasticity for the last 20 years. In Norway, the treatment is now offered to two out of three children with spastic cerebral palsy (CP). However, despite its common use, the evidence for its functional effects is limited and inconclusive. The objective of this study is to determine whether BoNT-A makes walking easier in children with CP. We hypothesize that injections with BoNT-A in the calf muscles will reduce energy cost during walking, improve walking capacity, increase habitual physical activity, reduce pain and improve self-perceived performance and satisfaction...
February 6, 2017: Trials
https://www.readbyqxmd.com/read/28145586/botulinum-toxin-and-safety-issues-in-cerebral-palsy
#14
Eugenia Yiannakopoulou
No abstract text is available yet for this article.
March 2017: Developmental Medicine and Child Neurology
https://www.readbyqxmd.com/read/28099276/factors-in-the-efficacy-safety-and-impact-on-quality-of-life-for-treatment-of-drooling-with-botulinum-toxin-type-a-in-patients-with-cerebral-palsy
#15
Maria D Gonzalez-L, Carmen Martinez, Inma Bori Y Fortuny, Santiago Suso-Vergara
OBJECTIVE: To assess the efficacy and safety of botulinum toxin A (BoNT-A) injected in both submandibular and parotid versus only in parotid glands as a treatment for drooling in patients with spastic and dyskinetic cerebral palsy (CP), including an assessment of impact on quality of life (QoL) based on items from the International Classification of Functioning, Disability, and Health (ICF) core set. DESIGN: Forty patients with CP 18 years or older (mean, 21.8 years) participated in a prospective, single-center, randomized controlled interventional study...
February 2017: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/28092243/-botulinum-toxin-a-and-physical-therapy-in-gait-in-cerebral-palsy
#16
Sandra Fabiola García-Sánchez, María Teresa Gómez-Galindo, Jaime Eduardo Guzmán-Pantoja
BACKGROUND: Cerebral palsy (PCI) is the leading cause of disability in children. Botulinum toxin type A (TBA) is a treatment to improve the function and pattern in the gait, although with a few studies that quantify the improvement. METHODS: Quasi-experimental study was conducted from May 2010 to September 2011, in Integrated Rehabilitation Center, in 36 patients with spastic PCI. Was evaluated: functionality of travel by the scale of Koman, speed of the gait with tone scale of Ashworth and arches of passive mobility, were applied TBA and was sent to 10 sessions of physical therapy, with measurements taken before, the 1st and 4th month...
January 2017: Revista Médica del Instituto Mexicano del Seguro Social
https://www.readbyqxmd.com/read/28081026/the-effect-of-nebulized-glycopyrrolate-on-posterior-drooling-in-patients-with-brain-injury-two-cases-of-different-brain-lesions
#17
Zee-Ihn Lee, Kwang Jae Yu, Dae Hee Lee, Seong Kyung Hong, Seung Beom Woo, Jong Min Kim, Donghwi Park
Posterior drooling, which can lead to substantial respiratory morbidity, including unexplained lung diseases and recurrent pneumonia, is an important issue in the rehabilitation unit. There are various treatment options for posterior drooling, including pharmacologic therapy, oral motor or behavioral therapy, biofeedback, local glandular injection of botulinum toxin, irradiation, and surgery. Among them, nebulized glycopyrrolate has the following advantages: It is noninvasive and is relatively free of central adverse effects because it does not cross the blood-brain barrier unlike other anticholinergics...
January 9, 2017: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/28081025/transdermal-scopolamine-withdrawal-syndrome-case-report-in-the-pediatric-cerebral-palsy-population
#18
Nasim A Chowdhury, Mary Laura Sewatsky, Heakyung Kim
Sialorrhea in children with cerebral palsy (CP) results in aspiration, decreased social integration, and poor quality of life. Management options include transdermal anticholinergics such as the scopolamine patch. A controlled clinical trial has proven botulinum toxin (BTX) injections into the salivary glands are an effective alternative to transdermal anticholinergics with a safer side effect profile. Multiple studies of the injections in diverse populations demonstrate reduction in saliva production with improvement in quality of life and decrease in hospitalization-associated costs...
January 9, 2017: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/28024228/vector-field-statistics-for-the-analysis-of-time-varying-clinical-gait-data
#19
C J Donnelly, C Alexander, T C Pataky, K Stannage, S Reid, M A Robinson
BACKGROUND: In clinical settings, the time varying analysis of gait data relies heavily on the experience of the individual(s) assessing these biological signals. Though three dimensional kinematics are recognised as time varying waveforms (1D), exploratory statistical analysis of these data are commonly carried out with multiple discrete or 0D dependent variables. In the absence of an a priori 0D hypothesis, clinicians are at risk of making type I and II errors in their analyis of time varying gait signatures in the event statistics are used in concert with prefered subjective clinical assesment methods...
December 3, 2016: Clinical Biomechanics
https://www.readbyqxmd.com/read/28002866/botulinum-toxin-injections-in-musculoskeletal-disorders
#20
Ivan R B Godoy, Dean M Donahue, Martin Torriani
Botulinum toxin (BTX) is used for multiple clinical indications due to its ability to induce temporary chemodenervation and muscle paralysis. This property has supported its application in treating a variety of musculoskeletal conditions, especially those involving muscular hyperactivity and contractures such as cerebral palsy and dystonia. However, off-label use of BTX injection in other musculoskeletal disorders is gaining increased acceptance, such as in neurogenic thoracic outlet syndrome, epicondylitis, and shoulder pain after stroke...
November 2016: Seminars in Musculoskeletal Radiology
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