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Self-estimated effect of treatment with botulinum toxin in the upper extremity of children with Cerebral Palsy (CP)

Linda Linné, Kerstin Sommerstein, Anette Chemnitz, Helena Erixon, Lars B. Dahlin.


Abstract
Objectives: National Swedish guidelines for treatment with botulinum toxin in children and adolescents with cerebral palsy (CP) include evaluation of self-estimated effects of treatment. We hypothesized that the treatment effect subsides after the first injection.
Methods: Children (or their parents), receiving their first botulinum toxin treatment of upper limb before the age of 20 years, filled in a questionnaire (visual analog scale; VAS) six weeks after each injection.
Results: Eighty-one out of 95 children or adolescents were evaluated (35% girls; 65% boys; 61% unilateral; 34% bilateral; 5% dyskinetic). Patients with unilateral CP were younger (median 8, range 1-19 years) than those with bilateral CP (12.5, 4-19 years; p<0.01). Patients with uni- and bilateral CP showed a sufficient [first injection median 64 (0-100) and 63 (0-100), respectively], and a sustained or better effect after two or three injections. The effect was also noted in patients divided by indication [i.e. prophylaxis contracture; 48 (0-100); improved positioning; 65 (11-100); improve hand function; [64 (0-100)]. Discomfort by the injection had a tendency to decrease after the first injection.
Conclusion: The self-estimated effect of treatment with botulinum toxin treatment is sufficient and does not deteriorate after the first injection in uni- and bilateral CP.

Key words: Botulinum toxin type A, cerebral palsy, children, self-estimated effect, upper extremity

 

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How to Cite this Article
Pubmed Style

Linda Linné| Kerstin Sommerstein| Anette Chemnitz| Helena Erixon| Lars B. Dahlin. Self-estimated effect of treatment with botulinum toxin in the upper extremity of children with Cerebral Palsy (CP). Hand Microsurg. 2018; 7(3): 135-142. doi:10.5455/handmicrosurg.298304


Web Style

Linda Linné| Kerstin Sommerstein| Anette Chemnitz| Helena Erixon| Lars B. Dahlin. Self-estimated effect of treatment with botulinum toxin in the upper extremity of children with Cerebral Palsy (CP). http://handmicrosurgeryjournal.com/?mno=298304 [Access: November 15, 2018]. doi:10.5455/handmicrosurg.298304


AMA (American Medical Association) Style

Linda Linné| Kerstin Sommerstein| Anette Chemnitz| Helena Erixon| Lars B. Dahlin. Self-estimated effect of treatment with botulinum toxin in the upper extremity of children with Cerebral Palsy (CP). Hand Microsurg. 2018; 7(3): 135-142. doi:10.5455/handmicrosurg.298304


Vancouver/ICMJE Style

Linda Linné| Kerstin Sommerstein| Anette Chemnitz| Helena Erixon| Lars B. Dahlin. Self-estimated effect of treatment with botulinum toxin in the upper extremity of children with Cerebral Palsy (CP). Hand Microsurg. (2018), [cited November 15, 2018]; 7(3): 135-142. doi:10.5455/handmicrosurg.298304


Harvard Style

Linda Linné| Kerstin Sommerstein| Anette Chemnitz| Helena Erixon| Lars B. Dahlin (2018) Self-estimated effect of treatment with botulinum toxin in the upper extremity of children with Cerebral Palsy (CP). Hand Microsurg, 7 (3), 135-142. doi:10.5455/handmicrosurg.298304


Turabian Style

Linda Linné| Kerstin Sommerstein| Anette Chemnitz| Helena Erixon| Lars B. Dahlin. 2018. Self-estimated effect of treatment with botulinum toxin in the upper extremity of children with Cerebral Palsy (CP). Hand and Microsurgery, 7 (3), 135-142. doi:10.5455/handmicrosurg.298304


Chicago Style

Linda Linné| Kerstin Sommerstein| Anette Chemnitz| Helena Erixon| Lars B. Dahlin. “Self-estimated effect of treatment with botulinum toxin in the upper extremity of children with Cerebral Palsy (CP).” Hand and Microsurgery 7 (2018), 135-142. doi:10.5455/handmicrosurg.298304


MLA (The Modern Language Association) Style

Linda Linné| Kerstin Sommerstein| Anette Chemnitz| Helena Erixon| Lars B. Dahlin. “Self-estimated effect of treatment with botulinum toxin in the upper extremity of children with Cerebral Palsy (CP).” Hand and Microsurgery 7.3 (2018), 135-142. Print. doi:10.5455/handmicrosurg.298304


APA (American Psychological Association) Style

Linda Linné| Kerstin Sommerstein| Anette Chemnitz| Helena Erixon| Lars B. Dahlin (2018) Self-estimated effect of treatment with botulinum toxin in the upper extremity of children with Cerebral Palsy (CP). Hand and Microsurgery, 7 (3), 135-142. doi:10.5455/handmicrosurg.298304