Citation
J Haem Pract 2014; 1(2):J Haem Pract 2014; 1(2): 21-23. doi: 10.17225/jhp00020

Authors: Melanie Bladen, Karen Edwards, Kate Khair, Eleanor Main

Melanie Bladen
Haemophilia Centre, Great Ormond St Hospital for Children NHS Trust. , Great Ormond Street London WC1N 3JH, UK.

Karen Edwards
Movement Disorder Team, Great Ormond Street Hospital for Children NHS Trust, Great Ormond Street London WC1N 3JH, UK.

Kate Khair
Nurse Consultant
Haemophilia Centre, Great Ormond St Hospital for Children NHS Trust, Great Ormond Street London WC1N 3JH, UK.

Eleanor Main
Institute of Child Health, University College London, Portex Department, 6th Floor, Cardiac Wing, Institute of Child Health, University College London, 30 Guilford Street, London, WC1N 1EH.

Abstract

Intramuscular botulinum toxin-A (BtA) to produce neuromuscular blockade has been effective in treating spasticity in children with cerebral palsy (CP) [1-3]. The use of BtA in children with a combination of CP and haemophilia has not previously been reported. We report a case of a 2-year-old boy with severe haemophilia and CP who received intramuscular injections of BtA to reduce his spastic diplegia lower limb hypertonicity.

Acknowledgements

The authors stated that they had no interests, which might be perceived as posing a conflict or bias.

References

  1. Carr LJ, Cosgrove AP, Gringas P, Neville BGR, on behalf of the UK Botulinum Toxin and cerebral palsy working party. Position paper on the use of botulinum toxin in cerebral palsy. Arch Dis Child 1998; 79: 271-273
  2. Delgado MR, Hirtz D, Aisen M, et al. Practice Parameter: Pharmocologic treatment of spasticity in children and adolescents with cerebral palsy (an evidence-based review) Report of the quality standards subcommittee of the child neurology society. Neurology 2010; 74: 336-343.
  3. Love SC, Novak I, Kentish M, et al. Botulinum toxin assessment, intervention and after care for lower limb spasticity in children with cerebral palsy:international consensus statement. European J Neurol 2010, 17 (Suppl) 9-37.
  4. Corry IS, Cosgrove AP, Duffy CM, et al. Botulinum toxin A compared with stretching casts in the treatment of spastic equines: a randomized prospective trial. J Ped Orthopaedics 1998, 18, 304-311.
  5. Cosgrove AP, Corry IS, Graham HK. Botulinum toxin in the management of the lower limb in cerebral palsy. Dev Med Child Neurol 1994; 36: 386-396.
  6. Graham HK, Aokia KR, Autti-Ramob, et al. Recommendations for the use of botulinum toxin type A in the management of cerebral palsy. Gait Posture 2000; 11:67-79.
  7. Ward A. Long-term modifications of spasticity. J Rehabil Med 2003; 35: 60-65.
  8. de Paiva A, Muenier FA, Molgo J, et al. Functional repair of motor endplates after botulinum neurotixin type A poisoning:biphasic switch of synaptic activity between nerve sprouts and their parent terminals. Proc Natl Acad Sci USA 1999; 96: 3220-5.
  9. Boyd RN, Graham HK. Objective measurement of clinical findings in the use of botulinum toxin type A for the management of children with cerebral palsy. European J Neurol 1999; 6 (Suppl): 23-35.
  10. Ashworth B. Preliminary trial of carisoprodal in multiple sclerosis. Practitioner 1964; 192: 540-542.
  11. Palisanao R, Rosenbaum P, Walter S, et al. Development and reliability of a system to classify gross motor function in children with cerebral palsy. Dev Med Child Neurol 1997; 39: 214-233.

The Journal of Haemophilia Practice is published by Haemnet.

Haemnet is a registered charity that brings together and gives a voice to haemophilia nurses, physiotherapists and allied health care professionals, providing forums for collaborative research, educational activities and support.