Botulinum toxin is a natural purified
protein and one of the strongest
biological poisons--
neurotoxin. It is produced by the bacterium Clostridium botulinum. Its medical usage started in USA in 1981 and in Europe in 1992. There are seven different immune types of the toxin: A, B, C1, D, E, F and G. Toxin types A and B are used to decrease muscular spasticity.
Botulinum toxin prevents the formation of
acetylcholine from
cholinergic nerve tissues in muscles, which in the end irreversibly destroys neuromuscular synapses. It is called temporary local
chemodenervation. It does not affect the synthesis of
acetylcholine. As it affects neuromuscular bond it also affects one of the symptoms of
cerebral palsy--spasticity. Decreasing the spasticity of children with
cerebral palsy leads to the improvement of conscious movements, muscles are less toned, passive mobility is improved,
orthosis tolerance is also improved, and the child is enabled to perform easier and better motor functions such as crawling, standing and walking. Since the action of
Botulinum toxin is limited to 2-6 months, new neural collaterals are formed and neuromuscular conductivity is reestablished which in the end once again develops a
muscular spasm. This leads to a conclusion that
botulinum toxin should again be applied into
spastic muscles. It is very important for good effect of
Botulinum toxin to set the goals of the
therapy in advance. The goals include improvement of a function, prevention of contractions and
deformities, ease of care and decrease of
pain for children with
cerebral palsy. After application of
botulinum toxin, it is necessary to perform adequate and intensive physical treatment with regular monitoring of effects. This work shows a case of a boy with
spastic form of
cerebral palsy. After being rehabilitated using Vojta
therapy and Bobath concept and the conduct of certain physical procedures,
botulinum toxin is administered into his lower limbs' muscles and kinesiotherapy is intensified. After the administration of
botulinum toxin significant functional improvement is noted.