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Cerebral palsy toxin

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https://www.readbyqxmd.com/read/28949368/value-of-botulinum-toxin-injections-preceding-a-comprehensive-rehabilitation-period-for-children-with-spastic-cerebral-palsy-a-cost-effectiveness-study
#1
Fabienne Schasfoort, Annet Dallmeijer, Robert Pangalila, Coriene Catsman, Henk Stam, Jules Becher, Ewout Steyerberg, Suzanne Polinder, Johannes Bussmann
OBJECTIVE: Despite the widespread use of botulinum toxin in ambulatory children with spastic cerebral palsy, its value prior to intensive physiotherapy with adjunctive casting/orthoses remains unclear. DESIGN: A pragmatically designed, multi-centre trial, comparing the effectiveness of botulinum toxin + intensive physiotherapy with intensive physiotherapy alone, including economic evaluation. SUBJECTS/PATIENTS: Children with spastic cerebral palsy, age range 4-12 years, cerebral palsy-severity Gross Motor Function Classification System levels I-III, received either botulinum toxin type A + intensive physiotherapy or intensive physiotherapy alone and, if necessary, ankle-foot orthoses and/or casting...
September 26, 2017: Journal of Rehabilitation Medicine
https://www.readbyqxmd.com/read/28834868/outcomes-of-intrathecal-baclofen-therapy-in-patients-with-cerebral-palsy-and-acquired-brain-injury
#2
Young Kwon Yoon, Kil Chan Lee, Han Eol Cho, Minji Chae, Jin Woo Chang, Won Seok Chang, Sung-Rae Cho
Intrathecal baclofen (ITB) has been known to reduce spasticity which did not respond to oral medications and botulinum toxin treatment. However, few results have been reported comparing the effects of ITB therapy in patients with cerebral palsy (CP) and acquired brain injury. This study aimed to investigate beneficial and adverse effects of ITB bolus injection and pump therapy in patients with CP and to compare outcomes to patients with acquired brain injury such as traumatic brain injury and hypoxic brain injury...
August 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28825663/efficacy-of-repeated-botulinum-toxin-type-a-injections-for-spastic-equinus-in-children-with-cerebral-palsy-a-secondary-analysis-of-the-randomized-clinical-trial
#3
Bo Young Hong, Hyun Jung Chang, Sang-Jee Lee, Soyoung Lee, Joo Hyun Park, Jeong-Yi Kwon
Botulinum toxin A is considered an important tool to control spasticity in children with cerebral palsy. Several factors are known to affect the efficacy of botulinum toxin, such as dosage, appropriate muscle selection and application, age, and accompanying therapy. A multicenter, double-blind, randomized, prospective phase III clinical trial of botulinum toxin A for the treatment of dynamic equinus in 144 children with cerebral palsy was performed to compare the efficacies of letibotulinumtoxin A and onabotulinumtoxin A...
August 21, 2017: Toxins
https://www.readbyqxmd.com/read/28820439/efficacy-and-safety-of-letibotulinum-toxin-a-for-the-treatment-of-dynamic-equinus-foot-deformity-in-children-with-cerebral-palsy-a-randomized-controlled-trial
#4
Hyun Jung Chang, Bo Young Hong, Sang-Jee Lee, Soyoung Lee, Joo Hyun Park, Jeong-Yi Kwon
The objective of this clinical trial was to compare the efficacy and safety of letibotulinum toxin A and onabotulinum toxin A for improving dynamic equinus foot deformity in children with cerebral palsy (CP). In total, 144 children with spastic CP who had dynamic equinus foot deformity were assigned randomly to the Botulax group (injection of letibotulinum toxin A) or the Botox group (injection of onabotulinum toxin A). The Physician's Rating Scale (PRS), ankle plantar flexor spasticity using the Modified Tardieu Scale, the Gross Motor Function Measure (GMFM)-88, and the GMFM-66 were completed before injection and at 6, 12, and 24 weeks after injection...
August 18, 2017: Toxins
https://www.readbyqxmd.com/read/28818530/recent-developments-in-clinical-trials-of-botulinum-neurotoxins
#5
Antoniangela Cocco, Alberto Albanese
Botulinum neurotoxins (BoNTs) are increasingly used in clinical practice for several indications. Following the pioneering years of discoveries, the recent years have witnessed an increase of new indications and new toxin brands. We review here the clinical trials on BoNTs performed since 2014 and put them into perspective. We also review the ongoing trials listed by the National Institutes of Health registry (Clinicaltrials.gov). The following indications are reviewed here: blepharospasm, cervical dystonia, spasticity, cerebral palsy, urinary incontinence, headache, topical formulations, postoperative cardiac arrhythmia, keloids and scars...
August 14, 2017: Toxicon: Official Journal of the International Society on Toxinology
https://www.readbyqxmd.com/read/28741118/strategies-to-decrease-injection-site-pain-in-botulinum-toxin-therapy
#6
Lejla Paracka, Katja Kollewe, Florian Wegner, Dirk Dressler
Botulinum toxin is now used for numerous indications including dystonias, spasticity, cerebral palsy, hyperhidrosis, cosmetics and chronic migraine. It has to be injected into its target tissues thus causing injection site pain. We wanted to compare the efficacy of various analgesic interventions suggested for reduction of injection site pain. In 13 healthy controls, pain thresholds in the fingertips II and III bilaterally were determined by the Mechanical Pain Threshold Test and the Repetitive Pain Stimulation Test at baseline and under nitrous oxide/oxygen, ice spray, local anaesthetic cream and forearm ischaemia...
July 24, 2017: Journal of Neural Transmission
https://www.readbyqxmd.com/read/28735160/longitudinal-assessment-of-gait-quality-in-children-with-bilateral-cerebral-palsy-following-repeated-lower-limb-intramuscular-botulinum-toxin-a-injections
#7
Felicity A Read, Roslyn N Boyd, Lee A Barber
BACKGROUND: Serial lower limb intramuscular Botulinum toxin-A (BoNT-A) injections are administered to children with bilateral spastic cerebral palsy (BCP) to reduce spasticity, improve walking and functional mobility, and delay the need for orthopaedic surgery. Gait quality is clinically assessed following BoNT-A with 2D video gait assessments (2DVGA) using the Edinburgh Visual Gait Score (EVGS). AIM: To determine the effect of three consecutive treatment cycles of lower limb intramuscular BoNT-A injections on gait quality using the EVGS in children with BCP by retrospectively reviewing repeated 2DVGA measures...
July 20, 2017: Research in Developmental Disabilities
https://www.readbyqxmd.com/read/28724781/muscle-disuse-caused-by-botulinum-toxin-injection-leads-to-increased-central-gain-of-the-stretch-reflex-in-the-rat
#8
Jessica Pingel, Hans Hultborn, Lui Näslund-Koch, Dennis B Jensen, Jacob Wienecke, Jens Bo Nielsen
Botulinum toxin (Btx) is used in children with cerebral palsy and in other neurological patients to diminish spasticity and reduce the risk of development of contractures. We investigated changes in the central gain of the stretch reflex circuitry in response to Btx injection in the triceps surae muscle in rats. Experiments were performed in 21 rats. Eight rats were a control group, and 13 rats were injected with 6 IU of Btx in the left triceps surae muscle. Two weeks after Btx injection, larger monosynaptic reflexes (MSR) were recorded from the left (injected) than the right (noninjected) L4 + L5 ventral roots following stimulation of the corresponding dorsal roots...
October 1, 2017: Journal of Neurophysiology
https://www.readbyqxmd.com/read/28650877/the-resurgence-of-botulinum-toxin-injection-for-strabismus-in-children
#9
REVIEW
Marielle Mahan, J Mark Engel
PURPOSE OF REVIEW: The present review discusses recent advances in the use of botulinum toxin for the management of strabismus in children. RECENT FINDINGS: Botulinum toxin injection produces similar results compared to surgery for certain subtypes of strabismus, especially acute onset esotropia. It may be more effective in many subtypes of esotropia where surgery has been less reliable, including partially accommodative esotropia, esotropia associated with cerebral palsy, and thyroid eye disease...
September 2017: Current Opinion in Ophthalmology
https://www.readbyqxmd.com/read/28634003/spasticity-video-challenge-a-look-at-methods-for-addressing-difficult-cases
#10
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
#11
REVIEW
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...
August 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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
RANDOMIZED CONTROLLED TRIAL
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
#19
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
#20
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
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