Over 25 Years of Pediatric Botulinum Toxin Treatments : What Have We Learned from Injection Techniques, Doses, Dilutions, and Recovery of Repeated Injections?

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Sätilä , H 2020 , ' Over 25 Years of Pediatric Botulinum Toxin Treatments : What Have We Learned from Injection Techniques, Doses, Dilutions, and Recovery of Repeated Injections? ' , Toxins , vol. 12 , no. 7 , 440 . https://doi.org/10.3390/toxins12070440

Title: Over 25 Years of Pediatric Botulinum Toxin Treatments : What Have We Learned from Injection Techniques, Doses, Dilutions, and Recovery of Repeated Injections?
Author: Sätilä, Heli
Contributor organization: Päijät-Häme Welfare Consortium
HYKS erva
Date: 2020-07
Language: eng
Number of pages: 20
Belongs to series: Toxins
ISSN: 2072-6651
DOI: https://doi.org/10.3390/toxins12070440
URI: http://hdl.handle.net/10138/320825
Abstract: Botulinum toxin type A (BTXA) has been used for over 25 years in the management of pediatric lower and upper limb hypertonia, with the first reports in 1993. The most common indication is the injection of the triceps surae muscle for the correction of spastic equinus gait in children with cerebral palsy. The upper limb injection goals include improvements in function, better positioning of the arm, and facilitating the ease of care. Neurotoxin type A is the most widely used serotype in the pediatric population. After being injected into muscle, the release of acetylcholine at cholinergic nerve endings is blocked, and a temporary denervation and atrophy ensues. Targeting the correct muscle close to the neuromuscular junctions is considered essential and localization techniques have developed over time. However, each technique has its own limitations. The role of BTXA is flexible, but limited by the temporary mode of action as a focal spasticity treatment and the restrictions on the total dose deliverable per visit. As a mode of treatment, repeated BTXA injections are needed. This literature reviewed BTXA injection techniques, doses and dilutions, the recovery of muscles and the impact of repeated injections, with a focus on the pediatric population. Suggestions for future studies are also discussed.
Subject: botulinum toxin type A
cerebral palsy
injection techniques
dosage
dilution
motor endplate targeted injections
muscle atrophy
repeated injections
MANUAL NEEDLE PLACEMENT
SPASTIC CEREBRAL-PALSY
LOWER-LIMB SPASTICITY
NEUROTOXIN TYPE-A
NERVE DISTRIBUTION PATTERNS
RANDOMIZED CONTROLLED-TRIAL
ACQUIRED BRAIN INJURY
GASTROCNEMIUS-MUSCLE
DOUBLE-BLIND
UPPER EXTREMITY
3112 Neurosciences
Peer reviewed: Yes
Rights: cc_by
Usage restriction: openAccess
Self-archived version: publishedVersion


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