Botulinum Toxin Injection in Children with Hemiplegic Cerebral Palsy: Correction of Growth through Comparison of Treated and Unaffected Limbs
1
Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul 03080, Korea
2
Department of Rehabilitation Medicine, National Traffic Rehabilitation Hospital, Gyeonggi-do 12564, Korea
3
Department of Rehabilitation Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
*
Author to whom correspondence should be addressed.
Toxins 2019, 11(12), 688; https://doi.org/10.3390/toxins11120688
Received: 16 October 2019 / Revised: 18 November 2019 / Accepted: 22 November 2019 / Published: 23 November 2019
(This article belongs to the Special Issue Effects of Botulinum Toxin on Functional Recovery after Injuries of Nervous System)
Botulinum toxin type A (BoNT-A) injections in children with cerebral palsy (CP) may negatively affect muscle growth and strength. We injected BoNT-A into the affected limbs of 14 children (4.57 ± 2.28 years) with hemiplegic CP and exhibiting tip-toeing gait on the affected side and investigated the morphological alterations in the medial head of the gastrocnemius muscle (GCM). We assessed thickness of the GCM, fascicle length, and fascicle angle on the affected and unaffected sides at baseline at 4 and 12 weeks after BoNT-A injections. The primary outcome measure was the change (percentage) in GCM thickness in the affected side treated with BoNT-A in comparison with the unaffected side. The percentage of treated GCM thickness became significantly thinner at 4 and 12 weeks after BoNT-A injection than baseline. However, the percentage of fascicle length and angle in treated limbs showed no significant change from baseline 4 and 12 weeks after the injection. BoNT-A injections might reduce muscle thickness in children with spastic hemiplegic CP. Fascicle length and angle might not be affected by BoNT-A injections after correction of normal growth of the children.
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Keywords:
muscle thickness; botulinum toxin; fascicle angle; fascicle length; hemiplegic cerebral palsy
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MDPI and ACS Style
Yi, Y.G.; Jang, D.-H.; Lee, D.; Oh, J.-Y.; Han, M.-H. Botulinum Toxin Injection in Children with Hemiplegic Cerebral Palsy: Correction of Growth through Comparison of Treated and Unaffected Limbs. Toxins 2019, 11, 688.
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