[article]
| Titre : |
Botulinum toxin type A or selective neurotomy for treating focal spastic muscle overactivity? |
| Type de document : |
texte imprimé |
| Auteurs : |
Thierry Deltombe ; Thierry Lejeune ; Thierry Gustin |
| Année de publication : |
2019 |
| Article en page(s) : |
p. 220-224 |
| Note générale : |
https://doi.org/10.1016/j.rehab.2018.07.008 |
| Langues : |
Anglais (eng) |
| Mots-clés : |
Hemiplegia Muscle spasticity Motor nerve block Neurotomy Equinovarus foot |
| Résumé : |
Objective
To discuss the effectiveness, indications, limitations and side effects of botulinum toxin type A and selective neurotomy for treating focal spastic muscle overactivity to help clinicians choose the most appropriate treatment.
Methods
Expert opinion based on scientific evidence and personal experience.
Results
Botulinum toxin type A can decrease muscle tone in different types of spastic muscle overactivity, which allows for treating a large variety of spastic patterns with several etiologies. The toxin effect is sometimes insufficient to improve functional outcome and is transient, thereby requiring repeated injections. Selective neurotomy is a permanent surgical treatment of the reflex component of the spastic muscle overactivity (spasticity) that is effective for spastic equinovarus foot. The neurotomy provides a greater and more constant reduction in spasticity. However, the long-lasting effect on the non-reflex muscle overactivity, especially dystonia, is doubted. The effectiveness, clinical indications, advantages, side effects and limitations of both techniques are discussed.
Conclusion
Botulinum toxin type A has the highest level of evidence and the largest range of indications. However, the botulinum toxin effect is reversible and seems less effective, which supports a permanent surgical treatment such as selective neurotomy, especially for the spastic foot. Further research is needed to compare the effect of botulinum toxin type A and selective neurotomy for the different types of spastic muscle overactivity and clinical patterns. |
| En ligne : |
https://www.sciencedirect.com/science/article/pii/S1877065718314398 |
| Permalink : |
./index.php?lvl=notice_display&id=84126 |
in Annals of physical and rehabilitation medicine > Vol. 62, n°4 (Juillet 2019) . - p. 220-224
[article] Botulinum toxin type A or selective neurotomy for treating focal spastic muscle overactivity? [texte imprimé] / Thierry Deltombe ; Thierry Lejeune ; Thierry Gustin . - 2019 . - p. 220-224. https://doi.org/10.1016/j.rehab.2018.07.008 Langues : Anglais ( eng) in Annals of physical and rehabilitation medicine > Vol. 62, n°4 (Juillet 2019) . - p. 220-224
| Mots-clés : |
Hemiplegia Muscle spasticity Motor nerve block Neurotomy Equinovarus foot |
| Résumé : |
Objective
To discuss the effectiveness, indications, limitations and side effects of botulinum toxin type A and selective neurotomy for treating focal spastic muscle overactivity to help clinicians choose the most appropriate treatment.
Methods
Expert opinion based on scientific evidence and personal experience.
Results
Botulinum toxin type A can decrease muscle tone in different types of spastic muscle overactivity, which allows for treating a large variety of spastic patterns with several etiologies. The toxin effect is sometimes insufficient to improve functional outcome and is transient, thereby requiring repeated injections. Selective neurotomy is a permanent surgical treatment of the reflex component of the spastic muscle overactivity (spasticity) that is effective for spastic equinovarus foot. The neurotomy provides a greater and more constant reduction in spasticity. However, the long-lasting effect on the non-reflex muscle overactivity, especially dystonia, is doubted. The effectiveness, clinical indications, advantages, side effects and limitations of both techniques are discussed.
Conclusion
Botulinum toxin type A has the highest level of evidence and the largest range of indications. However, the botulinum toxin effect is reversible and seems less effective, which supports a permanent surgical treatment such as selective neurotomy, especially for the spastic foot. Further research is needed to compare the effect of botulinum toxin type A and selective neurotomy for the different types of spastic muscle overactivity and clinical patterns. |
| En ligne : |
https://www.sciencedirect.com/science/article/pii/S1877065718314398 |
| Permalink : |
./index.php?lvl=notice_display&id=84126 |
|  |
Botulinum toxin type A or selective neurotomy for treating focal spastic muscle overactivity? in Annals of physical and rehabilitation medicine, Vol. 62, n°4 (Juillet 2019)
