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Early care and botulinum toxin. Our experience in the 21st century

J.L. Peña-Segura, M. Marco-Olloqui, R. Cabrerizo de Diago, R. Pérez-Delgado, A. García-Oguiza, M. Lafuente-Hidalgo, B. Sebastián-Torres, V. Rebage, J. López-Pisón [REV NEUROL 2008;47 (Supl. 1):S25-S33] PMID: 18767014 DOI: https://doi.org/10.33588/rn.47S01.2008347

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Volumen 47 | Number S01 | Nº of views of the article 4.619 | Nº of PDF downloads 1.078 | Article publication date 02/09/2008

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ABSTRACT

INTRODUCTION In neuropaediatrics, the aetiological diagnosis rarely allows a causal treatment to be established. In many cases, all we can offer is referral to early intervention (EI) and botulinum toxin type A (BTA). The only requirement before starting both interventions is a functional or syndromic diagnosis.

PATIENTS AND METHODS Here we analyse the experience gained from an EI programme carried out in the region of Aragon since February 2003 and with the BTA service in the Neuropaediatric Unit of the Hospital Universitario Miguel Servet since November 2003.

RESULTS By the end of 2007, 2629 requests had been made for admission to the EI programme and in the year 2007 a total of 702 children were treated. In four years and four months 122 children with infantile cerebral palsy (ICP) were infiltrated with BTA, with positive results in 70% of cases and mild, transient side effects in 13.1%.

CONCLUSIONS The children, parents and professionals involved all view EI and BTA with satisfaction. Neuropaediatrics is one of the medical specialties that are best suited to child development and early intervention centres (CDIAT). The neuropaediatrician participates in all the stages of the EI: detection, diagnosis, information and intervention. He or she may act as the coordinating and homogenising element in EI, that is to say, as a link between CDIAT and health care services. Neuropaediatricians are also essential in EI training and education, in family training, information and awareness campaigns, primary care, social services and nurseries. Treatment with BTA cannot be viewed as an isolated technique, but instead as part of a programme in which physiotherapy, orthosis and sometimes surgery play a fundamental role. Coordination among the different professionals involved in treating the child with ICP is absolutely crucial. KeywordsBotulinum toxin Early intervention Infantile cerebral palsy Neuropaediatrics

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Early care and botulinum toxin. Our experience in the 21st century