Effectiveness of botulinum toxin type A for pain control in children with spastic cerebral palsy
DOI:
https://doi.org/10.28957/rcmfr.v28n1a2Keywords:
Botulinum Toxin Type A, FLACC scale, children pain, spasticity, brain injury.Abstract
A prospective longitudinal analytical before and after study was performed in 12 pediatric patients between two and 18 years old with diagnosis of spastic cerebral palsy with limited communication, assessing the presence of pain by using the FLACC scale; the participants had indication for the administration of Botulinum Toxin type A for the control of spasticity. After this, the evaluation of the presence of pain was performed a week and a month after de administration of the myorelaxant material, in order to determine if there were any objective changes that may favor a better quality of life.
Materials and methods: A Prospective longitudinal non-experimental analytical before and after for related samples study was performed in children between 0 and 18 years of age with a diagnosis of spastic cerebral palsy and presence of pain reported by their parents. The Tstudent statistical test was performed for related samples analyzing the results of the FLACC pain scale before and after the administration of Botulinum Toxin Type A.
Results: A total of 15 patients were met, however, due the absence to controls and insufficient data provided by the parents, 3 cases were lost, obtaining a total of 12 patients included in the study, among them, by using the FLACC scale in the first assessment (FLACC1) seven patients (58.3%) evidenced the presence of moderate pain, four (33.3%) presented severe pain and one (8.3%) had mild pain; In the second assessment, one week after the administration of myorelaxant material (FLACC2), the results showed that four (33.3%) had moderate pain and eight (66.7%) had mild pain. Subsequently, in the third assessment, a month after the procedure (FLACC3), three (25%) of the patients presented moderate pain, eight (66.7%) had mild pain and one (8.3%) of them no longer presented any sign of pain. This showed that there are significant differences between pain values ?? before and after the application of myorelaxant material, suggesting the effectiveness of pain control with the administration of Botulinum Toxin type A.
Conclusions: The application of the FLACC scale to patients with spastic cerebral palsy allows an objective assessment of the level of pain in patients with limited communication and the application of botulinum toxin as myorelaxant material have significant beneficial effects in reducing pain in this population group.
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