Is Electrical Stimulation Beneficial for Improving the Paralytic Effect of Botulinum Toxin Type A in Children with Spastic Diplegic Cerebral Palsy?.
10.3349/ymj.2008.49.4.545
- Author:
Dong wook RHA
1
;
Eun Joo YANG
;
Ho Ik CHUNG
;
Hyoung Bin KIM
;
Chang il PARK
;
Eun Sook PARK
Author Information
1. Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Korea. pes1234@yuhs.ac
- Publication Type:Original Article ; Clinical Trial ; Research Support, Non-U.S. Gov't
- Keywords:
Botulinum toxin type A;
electrical stimulation;
cerebral palsy;
spasticity
- MeSH:
Botulinum Toxin Type A/*therapeutic use;
Cerebral Palsy/*drug therapy/*physiopathology;
Child, Preschool;
Electric Stimulation;
Electrophysiology;
Female;
Humans;
Male;
Paralysis/*drug therapy/*physiopathology
- From:Yonsei Medical Journal
2008;49(4):545-552
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: The purpose of the present study was to investigate whether electrical stimulation (ES) improves the paralytic effect of botulinum toxin type A (BTX-A) and evaluate the differences between low frequency (LF) and high frequency (HF) ES in children with spastic diplegic cerebral palsy (CP). MATERIALS and METHODS: Twenty-three children with spastic diplegia CP who had BTX-A injections into both gastrocnemius muscles were assessed. Following the toxin injection, electrical stimulation was given to 1 side of the injected muscles and a sham-stimulation to the other side for 30 min a day for 7 consecutive days [HFES (25Hz) to 11 children, LFES (4Hz) to 12 children]. The compound motor action potentials (CMAP) from the gastrocnemius muscle were assessed before injection and at 5 time points (days 3, 7, 14, 21, and 30) after injection. The clinical assessments of spasticity were performed before and 30 days after injection. RESULTS: The CMAP area became significantly lower in both LFES and HFES sides from 3 days after injection compared to baseline values. In other words, the CMAP area of the sham-stimulated side showed a significant decrease at 7 or 14 days after injection. However, there were no significant differences in clinical assessment of spasticity between the stimulated and sham-stimulated sides. CONCLUSION: Short-term ES in both LF and HF to the spastic muscles injected with BTX-A might induce earlier denervating action of BTX-A. However, it does not necessarily lead to clinical and electrophysiological benefits in terms of reduction of spasticity.
