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Botulinum toxin treatment of children with cerebral palsy - a short review of different injection techniques.

Authors
  • Schroeder, A S1
  • Berweck, S
  • Lee, S H
  • Heinen, F
  • 1 Dr. von Hauner's Children's Hospital, Department of Paediatric Neurology and Developmental Medicine, University of Munich, Germany. , (Germany)
Type
Published Article
Journal
Neurotoxicity research
Publication Date
April 2006
Volume
9
Issue
2-3
Pages
189–196
Identifiers
PMID: 16785117
Source
Medline
License
Unknown

Abstract

The intramuscular application of botulinum toxin type A (BoNT/A) has emerged to be an established treatment option to reduce muscular hyperactivity due to spasticity in children with cerebral palsy. Accurate injection is a prerequisite for efficient and safe treatment with BoNT/A. So far, treatment procedures have not been standardized. This paper is a short review of different injection techniques, i.e., manual needle placement as well as guidance by electromyography, electrical stimulation, and ultrasound. Advantages and disadvantages of the different injection techniques are discussed with a focus on needle positioning within the targeted muscle, injection close to the neuromuscular junction and diffusion of BoNT/A within the target muscles and through fascia. The additional information gained by each injection technique is weighed in terms of the clinical impact for children with cerebral palsy.

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