J Korean Acad Rehabil Med.  2006 Oct;30(5):455-461.

Efficacy of Single Event Multi-level Chemoneurolysis in Children with Cerebral Palsy

• Kim H
• Kim SW
• Wechsler B
• Kim CT
• Kwon BS

Abstract

OBJECTIVE
To investigate the efficacy of single event multi- level chemoneurolysis (SEMLC), a combination therapy of botulinum toxin and phenol for cerebral palsy (CP) with quadriplegia. METHOD: Fifty seven CPs with quadriplegia and 38 CPs with diplegia were injected botulinum toxin into as many small and distorted muscles as dose permitted, and then, phenol to the rest of muscles under conscious sedation. At three weeks after this procedure, patients were assessed for modified Ashworth scale (MAS) and range of motion (ROM). Changes of activities of daily living (ADL) and satisfaction with this procedure were investigated. Those assessments were compared between quadriplegia and diplegia.
RESULTS
MAS was reduced and ROM was improved in quadriplegia as much as those in diplegia. While the mobility function in diplegia improved more, the basic ADL functions in quadriplegia improved more than that in diplegia. Most patients experienced a decrease in pain after injection. Caregivers of both groups were quite satisfied with the procedure although some reported unmet expectations.
CONCLUSION
SEMLC enabled chemoneurolysis of enough levels of spastic muscles in CP with quadriplegia and lead to changes not only in spasticity and ROM but also in basic ADLs and pain.

Keyword

Botulinum toxin; Cerebral palsy; Phenol; Spasticity

MeSH Terms

Activities of Daily Living
Botulinum Toxins
Caregivers
Cerebral Palsy*
Child*
Conscious Sedation
Humans
Muscle Spasticity
Muscles
Phenol
Quadriplegia
Range of Motion, Articular
Botulinum Toxins
Phenol