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Journal of the Korean Academy of Rehabilitation Medicine 2006;30(5):455-461.
Efficacy of Single Event Multi-level Chemoneurolysis in Children with Cerebral Palsy.
Kim, Heakyung , Kim, Seong Woo , Wechsler, Barbara , Kim, Chong Tae , Kwon, Bum Sun
1The Section of Pediatric Rehabilitation, The Children's Hospital of Philadelphia and University of Pennsylvania School of Medicine, Philadelphia, USA.
2Department of Rehabilitation Medicine, NHIC Ilsan Hospital, Korea.
3Department of Pediatric Rehabilitation, Cleveland Clinic Children's Hospital for Rehabilitation, Cleveland, USA.
4Department of Rehabilitation, Dongguk University College of Medicine, Korea. bskwon@duih.org
일회성 다부위 신경융해술이 뇌성마비 아동의 치료에 미치는 효과
김혜경, 김성우1, BarbaraWechsler2, 김종태, 권범선3
The Children's Hospital of Philadelphia and University of Pennsylvania School of Medicine, 1국민건강보험공단 일산병원 재활의학과, 2Cleveland Clinic Children's Hospital for Rehabilitation, 3동국대학교 의과대학 재활의학교실
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. (J Korean Acad Rehab Med 2006; 30: 455-461)
Key Words: Botulinum toxin, Cerebral palsy, Phenol, Spasticity


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