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Severity of cerebral palsy and incidence of adverse events following botulinum toxin A injections
Author(s) -
S O’FLAHERTY,
A TILTON,
M GORMLEY
Publication year - 2017
Publication title -
developmental medicine and child neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.658
H-Index - 143
eISSN - 1469-8749
pISSN - 0012-1622
DOI - 10.1111/dmcn.02_13512
Subject(s) - cerebral palsy , incidence (geometry) , medicine , botulinum toxin , adverse effect , anesthesia , pediatrics , physical medicine and rehabilitation , physics , optics
alcohol and 20 were done with BTX-A only. Materials/Methods: Outcomes included improved function, decreased caregiver burden (scale of 1–10 of ease of cleaning, diapering, dressing and transferring), decreased pain (VAS scale 1–10). For salivary gland injections goals included decreased frequency of aspiration pneumonias, decreased caregiver burden (measured via frequency of suction, bib/clothes change), and patient comfort (subjective 1–10 scale). During follow up visits, patient/caregivers are asked to report whether ‘No Improvement’ ‘Somewhat Improved’ or ‘Goal Met or Exceeded’, as well as any negative outcomes. In order to decrease potential bias that patients that had less side effects may have had more injections or that patients may have been more or less likely to have side effects during first versus subsequent injection, we also analyzed first time injection side effects for ethanol and BTX-A versus BTX-A only. Results: There was no significant difference in improvements or side effects between the two groups. Looking at patient’s first injection, 89% of patients who received only BTX-A, and 89% of those who also received alcohol reported that goal was met or exceeded. Off all106 injections done (including repeat injections), 90% of the episodes of SEMLC with BTXA injections only versus 93% of episodes of SEMLC with alcohol and BTX-A resulted in goal being met or exceeded (p=0.687). The total number of side effects for all 106 injections was 8: One out of the 20 injections with BT only, and eight out of the 86 episodes with alcohol and BTX-A (p=0.471). Of patients receiving SEMLC for the first time, none of the patients that received BTX-A only had side effects and 14% of the patients that received alcohol in addition to BTX-A had side effects. This was not statistically significant (p=0.24). Side effects included leg weakness, injection site irritation, injection site infection, and thick mucus were all temporary. Conclusions/Significance: Patients who received SEMLC injections with alcohol in addition to BTX-A injections showed similar effect and no greater side effects compared to the BTX-A only group. Overall, there is low incidence of side effects and majority of patients reported improvement by both treatments.