Kurenkov A L, Klochkova O A, Zmanovskaya V A, Falkovskiy I V, Kenis V M, Vladykina L N, Krasavina D A, Nosko A S, Rychkova L V, Karimova Kh M, Bursagova B I, Namazova-Baranova L S, Mamedyarov A M, Kuzenkova L M, Dontzov O G, Ryzhenkov M A, Butorina M N, Pavlova O L, Harlamova N N, Dankov D M, Levitina E V, Popkov D A, Ryabykh S O, Medvedeva S N, Gubina E B, Agranovich O V, Kiseleva T I, Vasileva O N, Zykov V P, Mihnovich V I, Belogorova Т А
Scientific Centre of Children's Health of the Ministry of Health of the Russian Federation, Moscow, Russia.
Center for Restorative Treatment and Rehabilitation 'Nadezhda', Tymen, Russia.
Zh Nevrol Psikhiatr Im S S Korsakova. 2016;116(11):121-130. doi: 10.17116/jnevro2016116111121-130.
Spasticity treatment is one of the key aspects of the contemporary cerebral palsy (CP) rehabilitation that influences on the effectiveness of other methods. The paper presents the first Russian document that unites the recommendations for the BTA treatment of CP and could be used as the guideline for the multilevel injections. The Russian consensus on the multilevel botulinum toxin A (BTA) treatment of spastic CP is based on the international data and the results of national studies. The authors describe typical CP spasticity patterns in the upper and lower extremities, give recommended intervals for the BTA (Abobotulinum toxin A) dosages for the whole injection procedure and for the separate muscles. The method of dosage calculation for functional segments is also described. Attention is paid to the frequency, optimal intervals between the repeated injections and the whole duration of BTA treatment. The authors discuss effectiveness and safety of BTA, factors that potentially influence the results of the injections, including ultrasound and electromyography control, and indications for the continuation and termination of treatment.
痉挛治疗是当代脑瘫（CP）康复的关键环节之一，会影响其他治疗方法的效果。本文呈现了首份整合了肉毒杆菌毒素A（BTA）治疗脑瘫建议的俄罗斯文献，可作为多级注射的指导方针。俄罗斯关于多级肉毒杆菌毒素A（BTA）治疗痉挛型脑瘫的共识基于国际数据和国内研究结果。作者描述了上肢和下肢典型的脑瘫痉挛模式，给出了整个注射过程及各单独肌肉的BTA（阿扑肉毒杆菌毒素A）推荐剂量间隔。还描述了功能节段的剂量计算方法。文中关注了BTA治疗的频率、重复注射之间的最佳间隔以及整个疗程。作者讨论了BTA的有效性和安全性、可能影响注射结果的因素，包括超声和肌电图控制，以及治疗的继续和终止指征。
