Die Behandlung spastischer und dystoner Bewegungsstörungen mit BoNT/A bei Kindern mit Zerebralparese ist ein weltweit etabliertes interventionelles Therapieverfahren. Bei einer Vielzahl von Indikationen lassen sich Therapieerfolge auf Organebene (Tonussenkung) und zunehmend häufiger auch auf funktioneller Ebene (z. B. Verbesserung des Gangbildes und Handscores) erreichen. Idealerweise sollte die Versorgung in einem multidisziplinären Team erfolgen. Zur Therapieevaluation eignen sich individuelle Zielvereinbarungen und die Dokumentation mit Video. Während die Tonusreduktion bei Patienten mit spastischen Bewegungsstörungen mit hohem Evidenzgrad belegt ist, sind die funktionellen Langzeitauswirkungen weitgehend unklar und unzureichend verstanden.
Summary
The treatment with Botulinum toxin A of spastic and dystonic movement disorders in children with cerebral palsy is an internationally established interventional therapeutic procedure. For a number of indications therapy successes were demonstrated on the level of body structure and function (reduction of muscle tone), and beneficial results are more and more documented on the activity level (e. g. improvement of gait or hand scores). Ideally, treatment should be supplied by an interdisciplinary team. For evaluation purposes, individual goal attainment scaling and standardized video assessments are well suited. While reduction of muscle tone in spastic motor disorders can be regularly achieved on a high level of evidence, the long-term functional outcomes are less well examined and insufficiently understood.
Schlüsselwörter
bitte ergänzen !■■
Keywords
bitte ergänzen !■■
Literatur
1
SCPE..
Surveillance of cerebral palsy in Europe: a collaboration of cerebral palsy surveys and registers. Surveillance of Cerebral Palsy in Europe (SCPE). Dev Med Child Neurol 2000; 42 (12) 816-824.
4
Petruch U,
Weber PM,
Krageloh-Mann I.
SCPE obot..
The reference and training manual of the SCPE (Surveillance of Cerebral Palsy in Europe). Neuropediatrics 2004; 35: 63.
5
Palisano R.
et al.
Development and reliability of a system to classify gross motor function in children with cerebral palsy. Dev Med Child Neurol 1997 1997; 39 (04) 214-223.
6
Eliasson AC.
et al. Development and reliability of a system to classify hand function in children with cerebral palsy: Manual Ability Classification System (MACS). AACPDM; Orlando: 2005
7
Mall V.
et al.
Evaluation of botulinum toxin A therapy in children with adductor spasm by gross motor function measure. J Child Neurol 2000; 15 (04) 214-217.
9
Ostensjo S,
Carlberg EB,
Vollestad NK.
Everyday functioning in young children with cerebral palsy: functional skills, caregiver assistance, and modifications of the environment. Dev Med Child Neurol 2003; 45 (09) 603-612.
12
Koman LA.
et al.
Management of spasticity in cerebral palsy with botulinum-A toxin: report of a preliminary, randomized, double-blind trial. J Pediatr Orthop 1994; 14 (03) 299-303.
13
Heinen F.
et al.
The updated European Consensus 2009 on the use of Botulinum toxin for children with cerebral palsy. Eur J Paediatr Neurol 2010; 14 (01) 45-66.
15
Schroeder AS.
et al.
Muscle biopsy substantiates long-term MRI alterations one year after a single dose of botulinum toxin injected into the lateral gastrocnemius muscle of healthy volunteers. Mov Disord 2009; 24 (10) 1494-1503.
16
Chin TY,
Nattrass GR,
Selber P,
Graham HK.
Accuracy of intramuscular injection of botulinum toxin A in juvenile cerebral palsy: a comparison between manual needle placement and placement guided by electrical stimulation. J Pediatr Orthop 2005; 25 (03) 286-291.
17
Berweck S,
Schroeder AS,
Fietzek UM,
Heinen F.
Sonography- guided injection of botulinum toxin in children with cerebral palsy. Lancet 2004; 363 9404 249-250.
18
Lowe K,
Novak I,
Cusick A.
Low-dose/high-concentration localized botulinum toxin A improves upper limb movement and function in children with hemiplegic cerebral palsy. Dev Med Child Neurol 2006; 48 (03) 170-175.
20
Cardillo JE.
et al
Goal attainment scaling: applications, theory, and measurement. 1 ed. Hillsdale, New Jersey: Lawrence Erlbaum Ass. Publishers; 1994
21
Desloovere K.
et al. A randomized study of combined botulinum toxin type A and casting in the ambulant child with cerebral palsy using objective outcome measures. Eur J Neurol 2001; 8 (05) 75-87.
22
Rodda J,
Graham HK.
Classification of gait patterns in spastic hemiplegia and spastic diplegia: a basis for a management algorithm. Eur J Neurol 2001; 8 (05) 98-108.
23
Koman LA.
et al.
Botulinum toxin type A neuromuscular blockade in the treatment of lower extremity spasticity in cerebral palsy: a randomized, doubleblind, placebo-controlled trial. BOTOX Study Group. J Pediatr Orthop 2000; 20 (01) 108-115.
24
Mall V.
et al.
Treatment of adductor spasticity with BTX-A in children with CP: a randomized, doubleblind, placebo-controlled study. Dev Med Child Neurol 2006; 48 (01) 10-3.
25
Ubhi T.
et al.
Randomised double blind placebo controlled trial of the effect of botulinum toxin on walking in cerebral palsy. Arch Dis Child 2000; 83 (06) 481-487.
26
Molenaers G,
Desloovere K,
Nijs J.
The effect of an integrated BTA-A treatment on the gait pattern of children with CP. Dev Med Child Neurol 2001; 43 (88) 4-5.
27
Graham HK.
et al.
Does botulinum toxin a combined with bracing prevent hip displacement in children with cerebral palsy and hips at risk“? A randomized, controlled trial. J Bone Joint Surg Am 2008; 90 (01) 23-33.
28
Reeuwijk A,
van Schie PE,
Becher JG,
Kwakkel G.
Effects of botulinum toxin type A on upper limb function in children with cerebral palsy: a systematic review. Clin Rehabil 2006; 20 (05) 375-387.
29
Russo RN.
et al.
Upper-limb botulinum toxin A injection and occupational therapy in children with hemiplegic cerebral palsy identified from a population register: a single-blind, randomized, controlled trial. Pediatrics 2007; 119 (05) e1149-58.
31
Fehlings D,
Rang M,
Glazier J,
Steele C.
An evaluation of botulinum-A toxin injections to improve upper extremity function in children with hemiplegic cerebral palsy. J Pediatr 2000; 137 (03) 331-337.
35
Reid SM,
Johnson HM,
Reddihough DS.
The Drooling Impact Scale: a measure of the impact of drooling in children with developmental disabilities. Dev Med Child Neurol 2010; 52 (02) e23-28.
