Botulinumtoxin bei Zerebralparese

Zusammenfassung

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 Handfunktion) 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 function). 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

Zerebralparese - Botulinumtoxin - Spastizität

Keywords

Cerebral palsy - botulinum toxin - spasticity

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