Treatment of muscle spasticity in patients with cerebral palsy using BTX-A: a pilot study

Spec Care Dentist. 2004 Jul-Aug;24(4):235-9. doi: 10.1111/j.1754-4505.2004.tb01699.x.

Abstract

This study was designed to verify the safety and efficacy of botulinum toxin type A (BTX-A) used as a neuromuscular block on spastic masticatory musculature of children with cerebral palsy. Six patients who had spastic-tetraplegic cerebral-palsy, aged 5 to 20 years were selected. All patients had spasticity of the jaw muscles, bruxism, lower lip trauma, limited mouth opening, and difficulties in cleaning the oral cavity. The patients were sedated under general anesthesia, while the dentist injected the masseter and temporalis muscles bilaterally with 150 and 75 units of BTX-A each. Clinical examinations were conducted at 7, 14, 30, and 90 days after the initial appointment. We found statistically significant decreases in muscle spasticity and bruxism (p = 0.002), improved inter-incisal opening (p = 0.002), improved oral hygiene (p = 0.031), and less lower lip trauma (p = 0.060) after the neuromuscular blocking.

MeSH terms

  • Adolescent
  • Adult
  • Botulinum Toxins, Type A / therapeutic use*
  • Bruxism / therapy
  • Cerebral Palsy / therapy*
  • Child
  • Child, Preschool
  • Female
  • Follow-Up Studies
  • Humans
  • Lip / injuries
  • Male
  • Mandible / physiopathology
  • Masseter Muscle / physiopathology
  • Movement
  • Muscle Spasticity / therapy*
  • Neuromuscular Agents / therapeutic use*
  • Oral Hygiene
  • Pilot Projects
  • Safety
  • Temporal Muscle / physiopathology
  • Treatment Outcome

Substances

  • Neuromuscular Agents
  • Botulinum Toxins, Type A