Evaluation of the Results of Botulinum Toxin Injection in Children with Cerebral Palsy Aged between 2 and 15 years, using Two Techniques: Electrostimulation and Ultrasound

Abstract

Objective: The objective of our study is to compare ultrasound and electrostimulator guidance for the injection of diluted botulinum neurotoxin Type A. Materials and Methods: Eighty-six children were injected under a pacemaker and 94 under ultrasound. The injection involved the muscles of the lower limbs in 180 children aged between 2 and 15 years. Assessment was by the Modified Ashworth Scale, lower-limb range of motion, and Gross Motor Function Classification System (GMFCS) for function, as well as procedural pain. Results: The analysis does not find any difference between the two techniques concerning spasticity, functional evolution according to the GMFCS, and articular amplitudes, with the exception of the popliteal angle of the right knee with an estimated P = 0.01 for the group injected under ultrasound. Interventional pain between the two groups found a significant difference (P = 0.04) in favor of ultrasound identification. Conclusion: The stimulator had the same results as ultrasound on the orthopedic level of spasticity as well as on gross motor function. Nevertheless, ultrasound tracking remains more comfortable and less painful than stimulator tracking.

Keywords

• botulinum toxin a
• cerebral palsy
• electrostimulator
• spasticity
• ultrasound