Managing spasticity in children

Botulinum Toxin in Pediatric Neurology: Switching Lanes From Death to Life

Botulinum neurotoxins are natural molecules produced by anaerobic spore-forming bacteria called Clostradium boltulinum. The toxin has a peculiar mechanism of action by preventing the release of acetylcholine from the presynaptic membrane. Consequently, it has been used in the treatment of various neurological conditions related to muscle hyperactivity and/or spasticity. Also, it has an impact on the autonomic nervous system by acting on smooth muscle, leading to its use in the management of pain syndromes. The use of botulinum toxin in children separate from adults has received very little attention in the literature. This review presents the current data on the use of botulinum neurotoxin to treat various neurological disorders in children.

Challenging neurological symptoms in paediatric palliative care: An approach to symptom evaluation and management in children with neurological impairment

Neurological symptoms are very common in children with life-limiting conditions and are challenging in terms of burden of illness. Moreover, neurological symptoms can significantly impact the child's quality of life and contribute to distress among parents, families, caregivers and health care providers. Knowing how to manage and alleviated these symptoms is essential for providing good palliative care. In the present article, the more common neurological symptoms of agitation/irritability, spasticity and dystonia will be reviewed. The aim of the present brief review is to provide a basic approach to both the identification and treatment of these neurological symptoms. A medication table is provided for quick reference. A brief commentary and guidance for the management of pain are also incorporated, with reference to further literature sources.

Determination of basal metabolic rate and body composition with bioelectrical impedance method in children with cerebral palsy

This study uses the bioelectrical impedance method to assess the body composition, basal metabolic rate, and some other physical properties of children with cerebral palsy. In this study, 41 children with spastic cerebral palsy were assessed, and 56 normally developed children were included as control. Parameters such as body compositions, basal metabolic rate, body resistance, liquid compartment, and capacitance of patients and control group were measured and analyzed statistically. Basal metabolic rate, body mass index, extracellular liquid, intracellular liquid, body capacitance, and resistance differed significantly compared to the control group (P < .01), whereas extracellular mass, lean body mass, body cell mass, and fat mass did not differ significantly compared to the control group (P > .05). Parameters such as basal metabolic rate, body composition, and body resistance can be determined using the bioelectrical impedance method in children with cerebral palsy.