Uso da toxina botulínica tipo A no manejo dos membros inferiores espásticos em crianças com paralisia cerebral: relato de 4 casos
Keywords:
Spasticity, Botulinum Toxins, Type A, Cerebral PalsyAbstract
Four children w ith cerebral palsy age between 4 and 7 years old were selected for Bo tox Type A injection, presenting spastic diparesis with corrigible deformities and without orthopedic limitation. According to the protocol, after the injection all patients received daily physical therapy that consisted in stretching exercises for the injected muscles, strengtening of the antagonists, gait training and the use of an orthosis during the night: one patient was submitted to serial casting. During the period of 3 months, there was a monthly evaluation, measuring the R.O.M., Muscle Tone, Step lenght and width during gait and standing position. Results: significant gain in R.O.M. in a li patients, reduction position and gait patterns.
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References
Borodic GE, Ferrante R. Effects of repeated botulinum toxin injections on orbicularis oculi muscle. J Clin Neuroophthalmol. 1992;12(2):121-7. Doi: https://doi.org/10.3109/01658109209058127
Clinical Use of Botulinum Toxin. NIH Consens Statement. 1990;8(8):1-20.
Brin MF. Treatment of spasticity using local injections of botulinum toxin. The mount Sinai Medical Center Demostration Skills Workshop Series. 1995.
Das TK, Park DM. Effect of treatment with botulinum toxin on spasticity. Postgrad Med J. 1989;65(762):208-10. Doi: https://doi.org/10.1136/pgmj.65.762.208
Dimitrijevic MR. Spasticity. Curr Opin Neurol Neurosurg. 1990;3:742-5.
Drachman DB, Houk J. Effect of botulinum toxin on speed of skeletal muscle contraction. Am J Physiol. 1969;216(6):1453-5. Doi: https://doi.org/10.1152/ajplegacy.1969.216.6.1453
Frueh BR, Felt DP, Wojno TH, Musch DC. Treatment of blepharospasm with botulinum toxin. A preliminary report. Arch Ophthalmol. 1984;102(10):1464-8. Doi: https://doi.org/10.1001/archopht.1984.01040031184014
Hallet M. Several aspects of the clinical use of botulism toxin. Hand out for american academy of neurology after-dinner seminar. 1991.
Harris CP, Alderson K, Nebeker J, Holds JB, Anderson RL. Histologic features of human orbicularis oculi treated with botulinum A toxin. Arch Ophthalmol. 1991;109(3):393-5. Doi: https://doi.org/10.1001/archopht.1991.01080030095046
KOMAN, L.A.; MOONEY, J.F.; SMITH, B.P. Manejement of cerebral palsy with botulinum toxin. A randomized double-blind study. Dev. Med. Child, neurol., 34(suppl 66):23,1992.
Lange DJ, Brin MF, Warner CL, Fahn S, Lovelace RE. Distant effects of local injection of botulinum toxin. Muscle Nerve. 1987;10(6):552-5. Doi: https://doi.org/10.1002/mus.880100610
Lange DJ, Brin MF, Warner CL, Fahn S, Lovelac RE. Distant effects of local injection of botulinum toxin. Mov Dis. 1988;(4):333-5.
Lianza S, Gomes C, Santos CA, Silva JUA. Paralisia cerebral. In: Lianza S. Medicina de Reabilitação. Rio de Janeiro: Guanabara Koogan; 1995. p. 208-303.
Esquenazi A, Keenar MA. Gait analysis. In: DeLisa JA, Gans BM. Rehabilitation Medicine: principles and practice. Philadelphia: JB Lippincott; 1993.
Little JW, Merrit JL. Spasticity and associated abnormalities of muscle tone. In: Rehabilitation Medicine: principles and practice. Philadelphia: Lippincott; 1988.
Mark E, Gormley JR. M.D. Botox use in spasticity. 1994; (s.l.), (s.h.).
Montecucco C. How do tetanus and botulinum toxin bind to neural membranes? Trends Biomech Sci. 1986:11:314-7. Doi: https://doi.org/10.1016/0968-0004(86)90282-3
Sanders DB, Massey EW, Buckley EG. Botulinum toxin for blepharospasm: single-fiber EMG studies. Neurology. 1986;36(4):545-7. Doi: https://doi.org/10.1212/wnl.36.4.545
Schnider P, Brichta A, Schmied M, Auff E. Gallbladder dysfunction induced by botulinum A toxin. Lancet. 1993;342(8874):811-2. Doi: https://doi.org/10.1016/0140-6736(93)91580-f
Scott AB, Rosenbaum A, Collins CC. Pharmacologic weakening of extraocular muscles. Invest Ophthalmol. 1973;12(12):924-7.
Scott AB. Botulinum toxin injection of eye muscles to correct strabismus. Trans Am Ophthalmol Soc. 1981;79:734-70.
Scott AB, Suzuki D. Systemic toxicity of botulinum toxin by intramuscular injection in the monkey. Mov Disord. 1988;3(4):333-5. Doi: https://doi.org/10.1002/mds.870030409
Snow BJ, Tsui JK, Bhatt MH, Varelas M, Hashimoto SA, Calne DB. Treatment of spasticity with botulinum toxin: a double-blind study. Ann Neurol. 1990;28(4):512-5. Doi: https://doi.org/10.1002/ana.410280407
Tim R, Massey JM. Botulinum toxin therapy for neurologic disorders. Postgrad Med. 1992;91(6):327-32, 334. Doi: https://doi.org/10.1080/00325481.1992.11701332
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