Article

OBJECTIVE: To investigate the effect of a combination of botulinum toxin A
(BTX-A) and rehabilitation on spasticity, pain and motor functioning in children
with acquired brain injury (ABI). METHODS: All children and adolescents with ABI,
aged 2-20 years, consecutively treated in the department over a 22-month period,
were prospectively followed-up and clinically assessed pre- and post-treatment.
They had spasticity and/or dystonia leading to impairment in activities of daily
living, orthopaedic deformations and/or pain. Injections were performed using
electro-stimulation. Doses of BTX-A (Botox) were administered using recent
recommendations. RESULTS: Twenty-five children (mean age 6.3 years) participated
in the study (51 injection sessions). All patients received BTX-A injections,
followed with physical and/or occupational therapy. Significant improvement was
achieved for spasticity reduction (p < 0.0001), command on antagonist muscles (p
= 0.03 for the tibialis anterior) and goniometry assessment (p < 0.05). Pain
relief was achieved in patients in a minimally responsive state. Functional goals
were achieved, such as improving transfers or gait, grasping and releasing
abilities, with significant transfer in activities of daily living (p < 0.0001).
CONCLUSION: A combination of BTX-A injection with rehabilitation is an
interesting option for treatment of muscle tone disorders in children with ABI.

Langue : ANGLAIS