Electrophysiological Changes after Botulinum Toxin Type A in Children with Cerebral Palsy.

, Kim, Seong Woo; , Shin, Jung Bin; , You, Sung; , Kim, Hyoung Seop; , Nam, Ji Hyun; , Song, Sang Hyuk

Original Article

Journal of the Korean Academy of Rehabilitation Medicine 2010;34(2):179-184.

Kim, Seong Woo , Shin, Jung Bin , You, Sung , Kim, Hyoung Seop , Nam, Ji Hyun , Song, Sang Hyuk

Department of Rehabilitation Medicine, Ilsan Hostpital, National Health Insurance Corporation, Korea. nayanj@freechal.com

뇌성마비 아동에서 보툴리눔 독소 주사 후 전기생리학적 변화

김성우, 신정빈, 유 성, 김형섭, 남지현, 송상혁

국민건강보험공단 일산병원 재활의학과

Abstract

Objective
To investigate the electrophysiological changes after botulinum toxin type A injection in children with cerebral palsy.
Method
Sixteen children with spastic cerebral palsy enrolled in the study. Botulinum toxin type A (Dysport^Ⱂ) was injected into gastrocnemius muscles. Electrophysiological assessments included the compound motor action potential of the tibial nerve, the sensory nerve action potential of the sural nerve, the H-reflex and the T-reflex before injection, and at 2 weeks and 4 weeks after the injection. Modified Ashworth scale was used to evaluate spasticity before, 2 weeks and 4 weeks after the injection.
Results
Modified Ashworth scale of the ankle decreased at 2 weeks and 4 weeks after injection. The amplitude of the H-reflex and H_max/M_max ratio decreased significantly at 4 weeks. The amplitude of the T-reflex decreased at 2 weeks and 4 weeks. The correlation between changes in modified Ashworth scale of the ankle and the changes in electrophysiological parameters at 4 weeks after injection were not significant.
Conclusion
The change in T-reflex is faster than the change of H-reflex and H_max/M_max ratio after botulinum toxin A injection in children with cerebral palsy. Electrophysiological tests could quantify the change in spasticity after botulinum toxin injection. (J Korean Acad Rehab Med 2010; 34: 179-184)

Key Words: Cerebral palsy, Spasticity, Botulinum toxin, H-reflex, T-reflex