Botulinum toxin in the management of childhood muscle spasticity: comparison of clinical practice of 17 treatment centres

被引:32
|
作者
Bakheit, AMO
机构
[1] Peninsula Med Sch, Plymouth, Devon, England
[2] Plymouth Primary Care Trust, Plymouth, Devon, England
关键词
botulinum toxin; type A; spasticity;
D O I
10.1046/j.1468-1331.2003.00619.x
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
At least two randomized controlled trials (RCTs) have shown botulinum toxin type A (BtxA) to be efficacious and safe when used in the management of muscle spasticity in children. However, the need to use standard treatment protocols in these studies obscures some aspects of routine clinical practice that may have important effect on clinical outcomes. The purpose of this study was to seek additional information on the use of BtxA that is not usually captured by RCTs. This was performed by reviewing the clinical practice of practitioners in 17 treatment centres in Europe. The details of treatment with BtxA, including the dose, site and frequency of injections and the use of anaesthesia or sedation, were abstracted from the patient's records. Information was also obtained on the response to treatment and the occurrence and severity of adverse events. The data on 758 children who received a total of 1594 treatments in 17 different clinics in Europe were analysed. Ninety-four per cent of patients had cerebral palsy. There was a general agreement on the indications for treatment but the average dose of BtxA used varied between centres. One treatment centre used general anaesthesia (GA) prior to injections in most patients. The reported efficacy and adverse events pro. le was similar for all centres. The evidence from routine clinical practice for the efficacy and safety of BtxA in the management of muscle spasticity in children, as described in this study, is in agreement with that of most of the open-label and RCTs published to date. The present study also demonstrates the disagreement between clinicians on the optimal dose of BtxA for individual muscles and confirms that the injections can be carried out without GA in almost all cases.
引用
收藏
页码:415 / 419
页数:5
相关论文
共 50 条
  • [31] BOTULINUM TOXIN-A FOR SPASTICITY, MUSCLE SPASMS, AND RIGIDITY
    GRAZKO, MA
    POLO, KB
    JABBARI, B
    NEUROLOGY, 1995, 45 (04) : 712 - 717
  • [32] Notes for intramuscular botulinum toxin treatment of spasticity
    Stejskal, Lubor
    CESKA A SLOVENSKA NEUROLOGIE A NEUROCHIRURGIE, 2015, 78 (05) : 601 - 603
  • [33] Treatment of spasticity with injections of botulinum toxin type A
    Wissel, J.
    Mueller, J.
    NERVENHEILKUNDE, 2013, 32 (12) : 933 - 938
  • [34] Botulinum toxin A in treatment of cerebral palsy spasticity
    Carrelet, P
    Bollini, G
    Mancini, J
    Chabrol, B
    ARCHIVES DE PEDIATRIE, 2002, 9 (09): : 928 - 933
  • [35] Treatment of spasticity in cerebral palsy with botulinum toxin
    Calderón-González, R
    Calderón-Sepúlveda, RF
    REVISTA DE NEUROLOGIA, 2002, 34 (01) : 52 - 59
  • [36] Botulinum Toxin Treatment of Spasticity in Adults and Children
    Moeini-Naghani, Iman
    Hashemi-Zonouz, Taraneh
    Jabbari, Bahman
    SEMINARS IN NEUROLOGY, 2016, 36 (01) : 64 - 72
  • [37] BOTULINUM TOXIN-A (BTA) IN THE TREATMENT OF SPASTICITY
    PIERSON, SH
    KATZ, DI
    TARSY, D
    NEUROLOGY, 1994, 44 (04) : A184 - A184
  • [38] Use of Botulinum Toxin Type a in the Treatment of Spasticity
    Matur, Zeliha
    Parman, Yesim Gulsen
    NOROPSIKIYATRI ARSIVI-ARCHIVES OF NEUROPSYCHIATRY, 2010, 47 : 40 - 43
  • [39] Treatment of juvenile spasticity with botulinum toxin type A
    Desloovere, K.
    Molenaers, G.
    NERVENARZT, 2008, 79 : 19 - 21
  • [40] Spasticity management with botulinum toxin: A comparison of UK physiotherapy and rehabilitation medicine injectors
    Ashford, Stephen
    Nair, Ajoy
    Williams, Heather
    Esdon, James
    Steed, Aideen
    Nyein, Kyaw
    Turner-Stokes, Lynne
    INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION, 2018, 25 (05): : 215 - 222