Download PDF
CC BY 4.0 · Rev Bras Ortop (Sao Paulo) 2024; 59(06): e936-e943
DOI: 10.1055/s-0044-1792114
Artigo Original
Ortopedia Pediátrica

Efeitos da toxina botulínica sobre o tônus muscular e a mobilidade articular de crianças com síndrome congênita do Zika – Uma série de casos

Article in several languages: português | English
Patrícia Juliana da Silva 
1   Instituto de Pesquisa Professor Joaquim Amorim Neto (IPESQ), Campina Grande, PB, Brasil
,
Ana Stela Salvino de Brito 
1   Instituto de Pesquisa Professor Joaquim Amorim Neto (IPESQ), Campina Grande, PB, Brasil
,
Mariana Balbino da Silva 
1   Instituto de Pesquisa Professor Joaquim Amorim Neto (IPESQ), Campina Grande, PB, Brasil
,
Nathalia Nogueira Romariz Barros 
1   Instituto de Pesquisa Professor Joaquim Amorim Neto (IPESQ), Campina Grande, PB, Brasil
,
Jousilene Sales Tavares 
1   Instituto de Pesquisa Professor Joaquim Amorim Neto (IPESQ), Campina Grande, PB, Brasil
,
Gabriela Lopes Gama 
1   Instituto de Pesquisa Professor Joaquim Amorim Neto (IPESQ), Campina Grande, PB, Brasil
2   Universidade Federal de Juiz de Fora (UFJF), Governador Valadares, MG, Brasil
› Author Affiliations Suporte Financeiro Os autores declaram que não receberam suporte financeiro de agências nos setores público, privado ou sem fins lucrativos para realizar este estudo.
› Further Information
Also available at
   Permissions and Reprints

Resumo

Objetivo Avaliar os efeitos da toxina botulínica (BTX-A) sobre o tônus muscular e mobilidade articular de crianças com síndrome congênita do Zika (SCZ).

Métodos Trata-se de uma série de casos longitudinal realizada em um Centro de Apoio a Criança com Microcefalia, localizado no nordeste do Brasil. A coleta de dados foi realizada a partir dos prontuários dessa instituição, com o registro de informações sobre o tônus muscular e a mobilidade articular passiva, mensuradas pelo menos 3 meses antes e 4 semanas após a aplicação da BTX-A.

Resultados Foram avaliadas 13 crianças (9 meninos) com idade média de 77 ± 7,1 meses. Após a aplicação da BTX-A, foi observada redução bilateral do nível de hipertônia nos músculos flexores do cotovelo (p < 0,01) e adutores de quadril (p < 0,05) bilateralmente.

Conclusão Nenhuma mudança foi observada na mobilidade articular e nenhum efeito adverso foi relatado pelos cuidadores após a aplicação. O uso da BTX-A é capaz de promover a redução do nível de hipertonia de crianças com SCZ, sem impactar a mobilidade articular.

Palavras-chave

artrometria articular - espasticidade muscular - hipertonia muscular - infecção pelo Zika vírus

Trabalho desenvolvido Instituto de Pesquisa Professor Joaquim Amorim Neto (IPESQ), Campina Grande, PB, Brasil.




Publication History

Received: 30 January 2024

Accepted: 15 August 2024

Article published online:
21 December 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil

 

  • Referências

  • 1 Melo AS, Aguiar RS, Amorim MM. et al. Congenital Zika Virus Infection: Beyond Neonatal Microcephaly. JAMA Neurol 2016; 73 (12) 1407-1416
    CrossrefPubMedSearch in Google Scholar
  • 2 Tavares JS, Gama GL, Dias Borges MC. et al. Classification of Congenital Zika Syndrome: Muscle Tone, Motor Type, Body Segments Affected, and Gross Motor Function. Dev Neurorehabil 2021; 24 (05) 296-302
    CrossrefPubMedSearch in Google Scholar
  • 3 Melo A, Gama GL, Da Silva Júnior RA. et al. Motor function in children with congenital Zika syndrome. Dev Med Child Neurol 2020; 62 (02) 221-226
    CrossrefPubMedSearch in Google Scholar
  • 4 Pereira HVFS, Dos Santos SP, Amâncio APRL. et al. Neurological outcomes of congenital Zika syndrome in toddlers and preschoolers: a case series. Lancet Child Adolesc Health 2020; 4 (05) 378-387
    CrossrefPubMedSearch in Google Scholar
  • 5 Singhi P, Ray M. Botulinum toxin in children with cerebral palsy. Indian J Pediatr 2004; 71 (12) 1087-1091
    CrossrefPubMedSearch in Google Scholar
  • 6 Dietz V, Sinkjaer T. Spastic movement disorder: impaired reflex function and altered muscle mechanics. Lancet Neurol 2007; 6 (08) 725-733
    CrossrefPubMedSearch in Google Scholar
  • 7 Multani I, Manji J, Hastings-Ison T, Khot A, Graham K. Botulinum Toxin in the Management of Children with Cerebral Palsy. Paediatr Drugs 2019; 21 (04) 261-281
    CrossrefPubMedSearch in Google Scholar
  • 8 Jabbari B, Comtesse SM. Botulinum Toxin Treatment of Motor Disorders in Parkinson Disease-A Systematic Review. Toxins (Basel) 2023; 15 (02) 81
    CrossrefPubMedSearch in Google Scholar
  • 9 Ostrowski H, Roszak J, Komisarek O. Botulinum toxin type A as an alternative way to treat trigeminal neuralgia: a systematic review. Neurol Neurochir Pol 2019; 53 (05) 327-334
    PubMedSearch in Google Scholar
  • 10 Picelli A, Filippetti M, Sandrini G. et al. Electrical Stimulation of Injected Muscles to Boost Botulinum Toxin Effect on Spasticity: Rationale, Systematic Review and State of the Art. Toxins (Basel) 2021; 13 (05) 303
    CrossrefPubMedSearch in Google Scholar
  • 11 Kawamura A, Campbell K, Lam-Damji S, Fehlings D. A randomized controlled trial comparing botulinum toxin A dosage in the upper extremity of children with spasticity. Dev Med Child Neurol 2007; 49 (05) 331-337
    CrossrefPubMedSearch in Google Scholar
  • 12 Aktaş E, Ömeroğlu H. Botulinum toxin type A injection increases range of motion in hip, knee and ankle joint contractures of children with cerebral palsy. Eklem Hastalik Cerrahisi 2019; 30 (02) 155-162
    CrossrefPubMedSearch in Google Scholar
  • 13 Sales HF, Cerqueira C, Vaz D. et al. The impact of botulinum toxin type A in the treatment of drooling in children with cerebral palsy secondary to Congenital Zika Syndrome: an observational study. Neurol Res 2021; 43 (01) 54-60
    CrossrefPubMedSearch in Google Scholar
  • 14 Armani-Franceschi G, Luz C, Lucena PH. et al. Botulinum Toxin Type A in the Spasticity of Cerebral Palsy Related to Congenital Zika Syndrome: An Observational Study. Dev Neurorehabil 2022; 25 (03) 162-169
    CrossrefPubMedSearch in Google Scholar
  • 15 Bohannon RW, Smith MB. Interrater reliability of a modified Ashworth scale of muscle spasticity. Phys Ther 1987; 67 (02) 206-207
    CrossrefPubMedSearch in Google Scholar
  • 16 Marques AP. Manual de goniometria. 2a. ed.. Barueri: Manole; 2003
    Search in Google Scholar
  • 17 Bohannon RW. Comfortable and maximum walking speed of adults aged 20-79 years: reference values and determinants. Age Ageing 1997; 26 (01) 15-19
    CrossrefPubMedSearch in Google Scholar
  • 18 Sanger TD, Delgado MR, Gaebler-Spira D, Hallett M, Mink JW. Task Force on Childhood Motor Disorders. Classification and definition of disorders causing hypertonia in childhood. Pediatrics 2003; 111 (01) e89-e97
    CrossrefPubMedSearch in Google Scholar
  • 19 Lundy CT, Doherty GM, Fairhurst CB. Botulinum toxin type A injections can be an effective treatment for pain in children with hip spasms and cerebral palsy. Dev Med Child Neurol 2009; 51 (09) 705-710
    CrossrefPubMedSearch in Google Scholar
  • 20 Thorley M, Donaghey S, Edwards P. et al. Evaluation of the effects of botulinum toxin A injections when used to improve ease of care and comfort in children with cerebral palsy whom are non-ambulant: a double blind randomized controlled trial. BMC Pediatr 2012; 12: 120
    CrossrefPubMedSearch in Google Scholar
  • 21 Cosgrove AP, Corry IS, Graham HK. Botulinum toxin in the management of the lower limb in cerebral palsy. Dev Med Child Neurol 1994; 36 (05) 386-396
    CrossrefPubMedSearch in Google Scholar
  • 22 Pin TW, Elmasry J, Lewis J. Efficacy of botulinum toxin A in children with cerebral palsy in Gross Motor Function Classification System levels IV and V: a systematic review. Dev Med Child Neurol 2013; 55 (04) 304-313
    CrossrefPubMedSearch in Google Scholar
  • 23 da Fonseca JO, de Oliveira Vianna RA, Carvalho FR. et al. The Hip of Children with Congenital Zika Syndrome: A Prospective Observational Study. J Pediatr 2023; 256: 27-32
    CrossrefPubMedSearch in Google Scholar
  • 24 Pone MVDS, Gomes da Silva TO, Ribeiro CTM. et al. Acquired Hip Dysplasia in Children with Congenital Zika Virus Infection in the First Four Years of Life. Viruses 2022; 14 (12) 2643
    CrossrefPubMedSearch in Google Scholar
  • 25 Smith LR, Lee KS, Ward SR, Chambers HG, Lieber RL. Hamstring contractures in children with spastic cerebral palsy result from a stiffer extracellular matrix and increased in vivo sarcomere length. J Physiol 2011; 589 (Pt 10): 2625-2639
    CrossrefPubMedSearch in Google Scholar
  • 26 Willerslev-Olsen M, Lorentzen J, Sinkjaer T, Nielsen JB. Passive muscle properties are altered in children with cerebral palsy before the age of 3 years and are difficult to distinguish clinically from spasticity. Dev Med Child Neurol 2013; 55 (07) 617-623
    CrossrefPubMedSearch in Google Scholar
  • 27 Howard JJ, Herzog W. Skeletal Muscle in Cerebral Palsy: From Belly to Myofibril. Front Neurol 2021; 12: 620852
    CrossrefPubMedSearch in Google Scholar
  • 28 Yana M, Tutuola F, Westwater-Wood S, Kavlak E. The efficacy of botulinum toxin A lower limb injections in addition to physiotherapy approaches in children with cerebral palsy: A systematic review. NeuroRehabilitation 2019; 44 (02) 175-189
    CrossrefPubMedSearch in Google Scholar