보툴리눔 독소의 희석 용적에 따른 뇌성마비 환아의 경직의 변화
The Effects of Dilution Volume of Botulinum Toxin A on the Spasticity of Children with Cerebral Palsy
1
조회
0
다운로드
2
인용
0
참고문헌
키워드
초록
Objective: To evaluate the effects of the dilution volume of botulinum toxin A on spasticity of children with cerebral palsy.Method: Total 18 legs of 9 children with cerebral palsy were enrolled. 100 units of botulinum toxin were diluted with 4 cc or 2 cc of normal saline and injected to the medial and lateral heads of Gastrocnemius. Modified Ashworth scale, modified Tardieu test and range of motion (ROM) of ankle and knee were measured. Measurements were obtained before and at 1, 7, 14, 30, 60, 90, and 180 days after injection, respectively.Results: Spasticity tested by modified Ashworth scale and modified Tardieu test decreased and ROM of ankle and knee increased after 14 days since injection in both groups (p＜0.05). In low dilution group, maximal ROM of ankle and knee was obtained at 30th day after injection. In high dilution group, maximal ROM of ankle and knee was achieved at 14th day after injection and maximal ROM of knee at 30th day after injection. However, there was no significant differences between high dilution group and low dilution group in different times.Conclusion: Management of spasticity with botulinum toxin in cerebral palsy was not related to dilution volume.
Abstract
Objective: To evaluate the effects of the dilution volume of botulinum toxin A on spasticity of children with cerebral palsy.Method: Total 18 legs of 9 children with cerebral palsy were enrolled. 100 units of botulinum toxin were diluted with 4 cc or 2 cc of normal saline and injected to the medial and lateral heads of Gastrocnemius. Modified Ashworth scale, modified Tardieu test and range of motion (ROM) of ankle and knee were measured. Measurements were obtained before and at 1, 7, 14, 30, 60, 90, and 180 days after injection, respectively.Results: Spasticity tested by modified Ashworth scale and modified Tardieu test decreased and ROM of ankle and knee increased after 14 days since injection in both groups (p＜0.05). In low dilution group, maximal ROM of ankle and knee was obtained at 30th day after injection. In high dilution group, maximal ROM of ankle and knee was achieved at 14th day after injection and maximal ROM of knee at 30th day after injection. However, there was no significant differences between high dilution group and low dilution group in different times.Conclusion: Management of spasticity with botulinum toxin in cerebral palsy was not related to dilution volume.
참고문헌 (23)
- Nelson KB, "Epidemiology of cerebral palsy", Adv Neurol, 19, pp.421~435 (1978)
- Sellin LC, "The action of butulinum toxin at the neuromuscular junction", Med Bil, 59, pp.11~20 (1981)
- Jankovic J, "Therapeutic uses of botulinum toxins", N Engl J Med, 324, pp.1186~1194 (1991)
- Koman LA, "Therapy with botulinum toxin in : Botulinum toxin: potential role in the management of cerebral palsy during childhood", pp.511~522 (1994), Marcel Dekker
- Cosgrove AP, "Botulinum toxin in the management of the lower limb in cerebral palsy", Dev Med Chil Neurol, 36, pp.386~396 (1994)
- Cosgrove AP, "Botulinum toxin A prevents the development of contractures in the hereditary spastic mouse", Dev Med Chil Neurol, 36, pp.379~385 (1994)
- Fehlings D, "An evaluation of botulinum-A toxin injections to improve upper extremity function in children with hemiplegic cerebral palsy", J Pediatr, 137, pp.331~337 (2000)
- Septh LA, "Botulinum toxin A and upper limb functional skills in hemiparetic cerebral palsy: a randomized trial in children receiving intensive therapy", Dev Med Child Neurol, 47, pp.468~473 (2005)
- National Institute of Health Consensus Development Conference Statement, "Conference Report, Clinical use of botulinum toxin.", Arch Neurol, 48, pp.1294~1298 (1991)
- Fulton JE, "Botulinum toxin. The Newport Beach experience", Dermatol Surg, 24, pp.1219~1224 (1998)
- Hardie RJ, "Botulinum toxin in muscle spasticity", J Neurol Neurosurg Psychiatry, 68, pp.689~690 (2000)
- Klein AW, "Dilution and storage of botulinum toxin", Dermatol Surg, 24, pp.1179~1180 (1998)
- Brin MF, "Dosing, administration, and a treatment algorithm for use of botulinum toxin A for adult-onset spasticity. Spasticity Study Group", Muscle Nerve, 6, pp.S2208~220 (1997)
- Boyd R, "Objective measurement of clinical findings in the use of botulinum toxin type A for the management of children with CP", Eur J Neurol, 6(4), pp.23~35 (1999)
- Shaari CM, "Quantifying how location and dose of botulinum toxin injections affect muscle paralysis", Muscle Nerve, 16, pp.964~969 (1993)
- Holland RL, "Nerve growth in botulinum toxin poisoned muscles", Neuroscience, 6, pp.1167~1179 (1981)
- Jin GE, "Histopathologic findings and muscle fiber conduction studies after intra-muscular injection of Botulinum toxin in rat", J Korean Acad Rehab Med, 22, pp.440~446 (2006)
- Alderson K, "Botulinum induced alteration of nerve-muscle interactions in the human orbicularis oculi following treatment for blepharospasm", Neurology, 41, pp.1800~1805 (1991)
- Inagi K, "Efficacy of repeated botulinum toxin injections as a function of timing", Ann Otol Rhinol Laryngol, 106, pp.1012~1019 (1997)
- Borodic GE, "Histologic assessment of dose-related diffusion and muscle fiber response after therapeutic botulinum A toxin injections", Mov Disorder Society, 9, pp.31~39 (1994)
- Han TR, "Changes in compound muscle action potentials according to the dilution volume of the Botulinum toxin type A", J Korean Acad Rehab Med, 25, pp.273~277 (2001)
- Shaari CM, "Quantifying the spread of botulinum toxin through muscle fascia", Laryngoscope, 101, pp.960~964 (1991)
- Francisco GE, "Botulinum toxin dosing and dilution", Am J Phys Med Rehabil, 83(10), pp.30~37 (2004)