Spread And Effectiveness Of Botulinum Neurotoxin A In Spastic Equinus In Cerebral Palsy
Status:
Completed
Trial end date:
2010-05-01
Target enrollment:
Participant gender:
Summary
Objectives. To study the short-term neurophysiological and clinical outcome of botulinum
toxin type A(BoNT-A), injected at standard doses, and assess toxin spread to neighboring
uninjected muscles in children with cerebral palsy.
Subjects and methods. The investigators studied 18 ambulatory children with dynamic equinus
foot deformity (mean age 6.1 years). The gastrocnemius muscle on the affected side was
injected with BoNT-A (Dysport, range from 8.9-19.4 U/kg). As the primary neurophysiological
outcome measure, compound muscle action potential (CMAP) areas were assessed in the lateral
gastrocnemius (LG) and tibialis anterior(TA) muscles on the treated and untreated side before
BoNT-A injections (T0), and on days 10 (T10), and 30 (T30) after injections. Clinical scales
were assessed and video gait was analyzed at all three time points.
Results. In all patients, CMAP areas recorded from the LG and TA muscles on the treated side
decreased significantly from pre-injection values at T10 (p<0.05) and T30 (p<0.002).
Assessment at both time points after injections also showed that ankle spasticity had
diminished (p<0.05), equinus foot excursion increased (p<0.05), and functional gait improved
(p<0.05).
Conclusion. Although BoNT-A injected at standard doses improves gait in children with spastic
equinus foot the toxin spreads to uninjected leg muscles. BoNT-A treatment for cerebral palsy
therefore needs individualizing according to the child's clinical features.
Phase:
Phase 4
Details
Lead Sponsor:
Universita di Verona
Treatments:
abobotulinumtoxinA Botulinum Toxins Botulinum Toxins, Type A incobotulinumtoxinA onabotulinumtoxinA