Neurology published a special article to evaluate the use of pharmacologic treatments for spasticity in children with cerebral palsy. The multidisciplinary panel reviewed articles from from 1966 through 2008. The panel concluded that Botulinum toxin type A was found to be generally safe although the FDA is currently investigated the use of the drug in children. Botox was found to be effective in reducing spasticity in the upper and lower extremities but there is inconsistent evidence regarding improvement in function. The panel concluded that that diazepam is effective in treating generalized spasticity along with tizanidine. There was inconclusive evidence on diazepam and tizanidine's effects on function. Regarding the use of phenol, alchohol, botox type B, dantrolene, oral baclofen, or continuous intrathecal baclofen, there was insufficient evidence to support or discredit their use.
Reference: Delgado, M. R., Hirtz, D., Aisen, M., Ashwal, S., Fehlings, D. L., McLaughlin, J., Morrison, L. A., Shrader, M. W., Tilton, A., Vargus-Adams, J.Practice Parameter: Pharmacologic treatment of spasticity in children and adolescents with cerebral palsy (an evidence-based review): Report of the Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology SocietyNeurology 2010 74: 336-343
2 comments:
Now here's some research I can trust on surface value, Margaret. Studies of drugs are better controlled, and a review of a specific type of study makes for good information. (Meta-analyisis?) I see many mixed references to Botox among the blogs I read - some referring to it as a 'poison'. I will be more sure in quoting its safety - from this article.
As to improvement in function from Botox, that is very dependent on the skill of the MD injecting. Seems that procedure would be enhanced by working with a therapist - ? Have you ever witnessed or learned how an SDR is done? Barbara
I have never witnessed the actual SDR surgery but I am familiar with how it is done. I have worked with several kids who have undergone the procedure. I have seen it be very successful and some not so successful. In my opinion, the not as successful ones were performed on children who were too young. I have noticed that doctor's with more experience get better results with botox and any surgical procedures for that matter.
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