BOTULINUM-A CHEMODENERVATION - A NEW MODALITY IN CEREBRAL-PALSIED HANDS

Botulinum A chemodenervation of the Adductor Pollicis muscle for the t reatment of the thumb-in-palm deformity in cerebral palsied hands is p resented as a new therapeutic option. Early results of a clinical tria l in five hemiparetic Cerebral Palsied (C.P.) children are assessed us ing a prospective nontrialist-biased study design based on an independ ent panel assessment of pre- and post-intervention photographic and vi deotaped records of hand function and appearance, in combination with grip dynamometry and goniometry. All cases are shown to improve in ter ms of both function and appearance with results approaching statistica l significance (p = 0.06) when assessed by the Wilcoxon's matched-pair s signed rank test, despite the small study group. The modality is sho wn to be simple, safe and effective over the period reported (229 days ). The benefit is sustained beyond the period of muscle paresis and on going long term follow-up will document the need for, and timing of, r einjection.