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 ORIGINAL ARTICLE
Year : 2017  |  Volume : 12  |  Issue : 4  |  Page : 338-343

Phenol versus botulinum toxin a injection in ambulatory cerebral palsy spastic diplegia: A comparative study


1 Assistant Professor in Physical Medicine and Rehabilitation, All India Institute of Medical sciences, Jodhpur, Rajasthan, India
2 Senior resident in Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
3 Department of Paediatrics, Sawai Mansingh Medical college, Jaipur, Rajasthan, India
4 Director of All India Institute of Physical Medicine and Rehabilitation, Mumbai, India
5 Assistant Professor, Departments of Biochemistry, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India

Correspondence Address:
Dr. Nitesh Gonnade
Assistant Professor in Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, Jodhpur, Rajasthan
India
Vaibhav Lokhande
Senior Resident in Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, Jodhpur, Rajasthan
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/JPN.JPN_123_17

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The aim of this study is to compare the treatment effectiveness of botulinum toxin type A (BTX-A) and phenol blocks in the management of lower limb spasticity and to measure improvement in gross motor functional outcome in children with cerebral palsy (CP). This is a hospital-based prospective, noncontrolled randomized study that took place in a tertiary care center. A total of 61 ambulatory children with CP spastic diplegia, aged from 4 to 10 years, were randomly divided into two groups and included in this study. Twenty-eight children with CP received BTX-A injections and 33 received phenol motor point blocks. The measures performed were as follows: outcome assessment spasticity by the Modified Ashworth scale (MAS), active range of motion (AROM) of lower limb joint by goniometer, and functional improvement by Gross Motor Function Measures (GMFM). Postinjection follow-up done at 2, 6, 12, 24, and 48 weeks. Significant improvement in reduction of spasticity, increased AROM of all joints of lower limbs, and improvement in functional outcome were observed in CP with spastic diplegia after BTX-A injections as compared with the phenol motor point block group. There was no significant side effect after BTX-A injections as compared with phenol injections. BTX-A injections showed superior treatment effects in the reduction of spasticity and improvement in AROM and functional outcome measures with spastic diplegia as compared with phenol blocks. BTX-A injections also revealed fewer clinical side effects and were well tolerated by children with CP.






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