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Spasticité

PO23-004 - Use of botulinum toxin type A in patients with hereditary spastic paraplegia (HSP), review of 5 cases

Dr Yerko IVANOVIC – Centro de referencia estatal de atención a personas con enfermedades raras y sus familias – Burgos, ESPAGNE

 

 

Aim

Hereditary spastic paraplegia (HSP) is characterized by lower extremity dynamic spasticity. Because of the results in other kinds of spasticity, the use of botulinum neurotoxin type A might also be considered for patients with HSP. We evaluate the objective and subjective improvement of patients by injecting botulinum toxin, analyzing the progress and ability to ambulate on uneven surfaces after a gait rehabilitation treatment, giving guidelines of gait rehabilitation standardized by the MD.

 

Material and method

We consider the following Facts: Tinetti scale of gait before and after treatment (botulinum toxin and 5 months and 2 sessions of physiotherapy per week. 20 minutes of the session are dedicated to muscle elongation and 40 minutes are dedicated to gait rehabilitation). The evaluation also checks: time that patient takes to walk 10 meters and step length, before and after treatment.

 

Result

After botulinum toxin injection of the gracilis and adductor and completing the rehabilitation treatment, time to travel the distance was reduced by almost half (45%) in all cases, and step length was increased over 25%. Tinetti scale was improved in 3 points in all cases.

 

Discussion

Botulinum toxin is useful in the management of dynamic spasticity of HSP, requiring also a proper gait re-education for periods of several months.

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