Botulinum Toxin Intervention in Cerebral Palsy-Induced Spasticity Management: Projected and Contradictory Effects on Skeletal Muscles

Spasticity, following the neurological disorder of cerebral palsy (CP), describes a pathological condition, the central feature of which is involuntary and prolonged muscle contraction. The persistent resistance of spastic muscles to stretching is often followed by structural and mechanical changes...

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Bibliographic Details
Published in:Toxins 2022-11, Vol.14 (11), p.772
Main Authors: Kaya Keles, Cemre Su, Ates, Filiz
Format: Article
Language:English
Subjects:
active muscle
Atrophy
Biomechanics
Botulinum toxin
Botulinum Toxins, Type A - therapeutic use
Care and treatment
Cerebral palsy
Cerebral Palsy - complications
Cerebral Palsy - drug therapy
Child
Complications and side effects
Connective tissue
Development and progression
Dosage and administration
Gait
Humans
Injections, Intramuscular
Joints (anatomy)
Morphology
Muscle contraction
Muscle Spasticity - drug therapy
Muscle Spasticity - etiology
Muscle, Skeletal
Muscles
Muscular function
Musculoskeletal system
Neurological diseases
Neuromuscular Agents - therapeutic use
Paralysis
passive muscle
Pathology
Patient outcomes
Quality of Life
Review
Risk factors
Skeletal muscle
spastic muscle
Spasticity
spasticity management
Stiffness
Toxins
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Description
Summary:Spasticity, following the neurological disorder of cerebral palsy (CP), describes a pathological condition, the central feature of which is involuntary and prolonged muscle contraction. The persistent resistance of spastic muscles to stretching is often followed by structural and mechanical changes in musculature. This leads to functional limitations at the respective joint. Focal injection of botulinum toxin type-A (BTX-A) is effectively used to manage spasticity and improve the quality of life of the patients. By blocking acetylcholine release at the neuromuscular junction and causing temporary muscle paralysis, BTX-A aims to reduce spasticity and hereby improve joint function. However, recent studies have indicated some contradictory effects such as increased muscle stiffness or a narrower range of active force production. The potential of these toxin- and atrophy-related alterations in worsening the condition of spastic muscles that are already subjected to changes should be further investigated and quantified. By focusing on the effects of BTX-A on muscle biomechanics and overall function in children with CP, this review deals with which of these goals have been achieved and to what extent, and what can await us in the future.
ISSN:2072-6651
2072-6651
DOI:10.3390/toxins14110772