SEREBRAL PALSİDE BOTULİNUM TOKSİNİNİN YERİ

Serebral palsi hareket ve duruþ bozukluklarý ile seyreden bir hastalýktýr. Serebral palsinin tedavi yöntemlerinden biri olan Botulinum toksin enjeksiyonu fokal spastisite tedavisinde etkin ve güvenilir bir yöntem olup, bu yazýda öncelikle serebral palsi, botulinum toksinin yapýsý, tedaviye uygun hasta seçimi, doz, enjeksiyon tekniði, enjeksiyon sonrasýndaki tedavi uygulamalarý gibi dikkat edilmesi gereken teknik konular üzerinde yoðunlaþýlacaktýr.
Anahtar Kelimeler:

Botulinum toksin, serebral, palsi

Role of botulinum toxin in cerebral palsy.

Cerebral Palsy is a disease that may show motion and posture disorders. One of the treatment methods of Botulinum toxin injection is a well tolerated, safe and effective procedure in the treatment of focal spasticity. In this article, cerebral palsy, structure of Botulinum toxin, then the technical issues including the selection of the patient suitable for treatment, the appropriate dosage, injection technique and aftercare have been discussed.

___

  • Badawi N, Watson L, Petterson B, et al. What constitute cerebral palsy. Dev Med Child Neurol 1998; 40:520- 7.
  • Graham H.K, Aoki K.R, Autti-Ramö I, Boyd R.N, Delgado M.R, Deborah J et all. Recommendation for the use of botulinum toxin type A in the management of cerebral palsy. Gait and Posture 11, 2000, 67-79.
  • Dabney KW, Lipton GE, Miller F. Cerbral palsy. Curr Opin Pediatr 1997; 9:81-8.
  • Cooper J, Majnemer A, Rosenblatt B, et al. The determination of sensory deficits in children with hemiplegic cerebral palsy. J Child Neurol 1995; 10:300- 9.
  • Russman BS. Cerebral plasy. Current treatment options. Neurology 2000; 2:97-108.
  • Anonymous. Surveillance of cerebral palsy in Europe (SSPE). Dev Med Child Neurol 2000; 42:816-24.
  • Çil A, Aksoy M.C, Çeliker R. Serebral palsi tedavisinde botulinum toksini uygulamalarý. Hacettepe Týp Dergisi 2006; 37:43-48.
  • Boyd R.N, Graham H.K. Objective measurement of clinical findings in the use of botulinum toxin type A for the management of children with cerabral palsy. Eur J Neurol 1999;(Suppl.4):523-35.
  • Sathyamurthy V, Dasgupta BR. Separation, purification, partial characterization and comparison of the heavy and light chains of botulinum neurotoxin types A, B, and E. J Biol Chem 1985; 260:10461-6.
  • Jankovic J, Hallet M, eds. Therapy with botulinum toxin. New York: Marcel Decker, 1994.
  • Moore P, ed. Handbook of botulinum toxin treatment. Oxford: Blackwell Science, 1995.
  • Carr LJ, Cosgrove AP, Gringrass P, et al. Position paper on the use of botulinum toxin in cerbral palsy. Arch Dis Child 1998; 79:271-3.
  • Mathiowetz V, Federman S, Wiemer D. Box and block test of manual dexterity: norms for 6-19 year olds. Can J Occup Ther 1985;52:241-5
  • Boyd R.N, Graham H.K. Botulinum toxin type A in the management of children with cerebral palsy: indications and outcome. Eur J Neurol 1997;4:S15- 22.
  • Delgado MR. The use of botulinum toxin type A in children with cerebral palsy: a retrospective study. Eur J Neurol 1999; 6(Suppl 4):11-8.
  • Bakheit AM, Severa S, Cosgrove A, et al. Safety profile of botulinum toxin (DYSPORT) in children with muscle spasticity. Dev Med Child Neurol 2001; 43:234-8.
  • Corry I, Cosgrove A, Duffy C, McNeil S, Taylor T,Graham H. Botulinum toxin type A compared with stretching cast in the treatment of spastic equinus, a randomised prospective trial. J Pediatr Orthop 1998;18:304-11.