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Benefits of botulinum toxin use in pediatric patients with spastic paralysis: Cases series from the children's hospital "Dr. Roberto Gilbert Elizalde"

Abstract:

Introduction: Infantile Cerebral Palsy (ICP) is the main cause of childhood disability and the most common spastic disorder in children. The use of botulinum toxin type A (BTA) has been reported as an effective treatment in this group of complications. The objective of the present study was to evaluate the effect of the application of BTA in patients with spasticity associated with ICP from the Children’s Hospital “Dr. Roberto Gilbert Elizalde “, Guayaquil, Ecuador. Methodology: A descriptive observational study was performed in pediatric patients evaluated in the Traumatology and Orthopedics service of the Children’s Hospital “Dr. Roberto Gilbert Elizalde”; the selection of the patients was through an intentional non-probabilistic sampling of those who underwent a complete clinical history that evaluated: gender, age, type of affectation, predominant laterality, and number of applications of previous BTA, as well as the muscle tone, before and after the application of the treatment, using the Ashworth scale. TBA was used at a dose of 20-40 IU/kg in one of the selected muscles. Results: 40 patients were evaluated, of which 63% were women (n=25), the overall age was 5.4±2.4. The evaluation of spasticity with the Ashworth scale prior to the application of BTA showed a higher frequency of patients in category 1 (43.3%, n=13), followed by category 3 (36.7%; n=11); after 1 month of the intervention, most subjects were placed in categories 0 and 1 (p=0.001). Conclusions: The present study is the first observational analysis of the effect of BTA in Ecuadorian patients with complications of PCI, our results confirm those reported in the literature, regarding the improvement of spasticity, specifically in muscle tone without any adverse effect after administration.