PMID: 15241761Jul 9, 2004Paper

Combining botulinum toxin and phenol to manage spasticity in children

Archives of Physical Medicine and Rehabilitation
Judith L Gooch, Christopher P Patton

Abstract

To describe the specific techniques and adverse reactions of using concurrent, multiple injections of both botulinum toxin and phenol to manage spasticity in children with cerebral palsy (CP) and other neurologic conditions. A retrospective case series. A tertiary care children's hospital. Consecutive patients (N=68) with spasticity related to CP or other neurologic conditions. Ninety injection sessions combining botulinum toxin and phenol to manage spasticity. Documentation of adverse reactions. The mean phenol dosage was 9.5mL at a mean of 0.6mL/kg per injection dose. The mean botulinum toxin type A (Botox) dose injected was 193U (12U/kg), and the mean of botulinum toxin type B (Myobloc) dose injected was 7750U (530U/kg). The mean number of muscles injected was 14. Adverse reactions are described but were infrequent. Dysesthetic hand pain occurred in 2 patients. One patient developed a systemic reaction to Myobloc. Using botulinum toxin and phenol injections allowed many muscles to be injected to manage spasticity in children with CP and other neurologic conditions. Using this combination allowed an increased number of injections at the maximal recommended dose.

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Citations

Mar 24, 2006·NeuroRx : the Journal of the American Society for Experimental NeuroTherapeutics·Ann H Tilton
Jun 22, 2006·American Journal of Physical Medicine & Rehabilitation·Matteo CioniBarbara Hirai
Nov 13, 2007·American Journal of Physical Medicine & Rehabilitation·Jeong-Yi Kwon, Joon-Sung Kim
Jan 5, 2008·American Journal of Physical Medicine & Rehabilitation·Jeong-Yi KwonWon Ihl Lee
Jun 25, 2008·American Journal of Physical Medicine & Rehabilitation·Kat KolaskiBeth P Smith
Dec 7, 2014·Physical Medicine and Rehabilitation Clinics of North America·Aaron Powell, Loren Davidson
Mar 29, 2011·Neurologic Clinics·Tanuja ChitnisEmmanuelle Waubant
Dec 25, 2010·Seminars in Pediatric Neurology·Ann TiltonMauricio R Delgado
Aug 1, 2009·Physical Medicine and Rehabilitation Clinics of North America·Diane L DamianoHenry Chambers
Jun 9, 2009·Seminars in Pediatric Neurology·Ann Tilton
Oct 22, 2008·Pediatric Clinics of North America·Nancy N Dodge
Oct 31, 2007·Physical Medicine and Rehabilitation Clinics of North America·Liza B Green, Edward A Hurvitz
Jul 1, 2009·Developmental Medicine and Child Neurology·Petr KanovskýUNKNOWN Dysport Paediatric Limb Spasticity Study Group
Jul 21, 2006·Movement Disorders : Official Journal of the Movement Disorder Society·Nam-Jong PaikHee Chul Eun
Jul 2, 2019·Paediatric Drugs·Iqbal MultaniKerr Graham
Jul 7, 2019·PM & R : the Journal of Injury, Function, and Rehabilitation·Jay KarriSheng Li

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