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Kurenkov A.L.

National Medical Research Center for Children’s Health

Klochkova O.A.

National Medical Research Center for Children’s Health

Kuzenkova L.M.

National Medical Research Center for Children’s Health

Bursagova B.I.

National Medical Research Center for Children’s Health

Karimova Kh.M.

National Medical Research Center for Children’s Health

Multilevel botulinum toxin treatment in severe spastic forms of cerebral palsy (GMFCS IV—V)

Authors:

Kurenkov A.L., Klochkova O.A., Kuzenkova L.M., Bursagova B.I., Karimova Kh.M.

More about the authors

Journal: S.S. Korsakov Journal of Neurology and Psychiatry. 2020;120(12): 57‑66

DOI: 10.17116/jnevro202012012157

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Table of contents

MULTILEVEL BOTULINUM TOXIN TREATMENT IN SEVERE SPASTIC FORMS OF CEREBRAL PALSY (GMFCS IV—V)
MULTILEVEL BOTULINUM TOXIN TREATMENT IN SEVERE SPASTIC FORMS OF CEREBRAL PALSY (GMFCS IV—V)

To cite this article:

Kurenkov AL, Klochkova OA, Kuzenkova LM, Bursagova BI, Karimova KhM. Multilevel botulinum toxin treatment in severe spastic forms of cerebral palsy (GMFCS IV—V). S.S. Korsakov Journal of Neurology and Psychiatry. 2020;120(12):57‑66. (In Russ.)
https://doi.org/10.17116/jnevro202012012157

Подписка 2026 Журнал неврологии и психиатрии им. С.С. Корсакова (S.S. Korsakov Journal of Neurology and Psychiatry)
МСФ на ЯМ
Использование инфографики авторами научных работ
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Abstract:

OBJECTIVE

To evaluate the most typical target muscles and dosages for the first and repeated botulinum toxin A (BTA) injections in cerebral palsy (CP) patients with severe motor deficit — GMFCS IV-V.

MATERIAL AND METHODS

A retrospective analysis of 677 protocols of the first and repeated Abobotulinumtoxin A (AboA) injections in 333 patients with CP GMFCS IV and V, aged 1 to 18 years, was carried out.

RESULTS

Ninety-seven percent of patients received multilevel injections. In the lower extremities the most typical target muscles were: m.gracilis — 221 (66.4%) patients, hip adductors — 164 (49.2%), medial hamstring — 144 (43.2%). In the upper extremities the most typical muscles were: m.pronator teres — 237 (71.2%) patients, m.biceps brachii+m.brachialis — 197 (59.2%). The total dosages of AboA and dosages for every target muscle were calculated. Several patients required high dosages (more than 30 U/kg of AboA). Higher dosages per kg were used in younger children and for repeated injections. The age-related evolution of spastic patterns was described. Adverse events were observed in 36 cases (5.3% of all injections).

CONCLUSION

The majority of patients with GMFCS IV-V required multilevel BTA injections in high dosages, especially in young age. Described selection of target muscles and dosages of AboA could be taken into account as a practical experience and reference for the BTA therapy in GMFCS IV-V patients.

Keywords:

cerebral palsy
spasticity
botulinum toxin
AbobotulinumtoxinA
non-ambulant children
GMFCS IV
GMFCS V

Authors:

Kurenkov A.L.

National Medical Research Center for Children’s Health

Klochkova O.A.

National Medical Research Center for Children’s Health

Kuzenkova L.M.

National Medical Research Center for Children’s Health

Bursagova B.I.

National Medical Research Center for Children’s Health

Karimova Kh.M.

National Medical Research Center for Children’s Health

Received:

16.10.2020

Accepted:

09.11.2020

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