PRIMENA BOTULINUM TOKSINA KOD SPASTIČNE CEREBRALNE PARALIZE, PREGLED LITERATURE
Sažetak
Tip A botulinum toksina je protein koji sintetiše bakterija Clostridium botulinum, a predstavlja jedan od najjačih toksina u prirodi. On je uzrok trovanja (botulizam), ali ima i povoljan uticaj na smanjenje mišićnog spazma, te je našao široku primenu u brojnim medicinskim disciplinama, pri čemu se indikacije iz godine u godinu povećavaju. Komplikacije su retke i bez većih posledica, ukoliko se pravilno dozira.
Ima povoljan uticaj na smanjenje mišićnog spazma u lečenju pacijenata sa cerebralnom paralizom spastičnog tipa. Dejstvo je lokalizovano, a sistemski neželjeni efekti se ne javljaju. Prihvatanje ove terapije od strane pacijenata je veoma dobro. Efekat na hod sačuvan je na zadovoljavajućem nivou između 3 i 6 meseci od primene. Interval između terapija iznosi oko 3 meseca, uz uslov da se obezbedi stalna kontrola motorne funkcije spastičnog ekstremiteta. Bolji rezultati primene postignuti su brže na pasivnim pokretima u odnosu na aktivne pokrete. Efekti su prolazni i reverzibilni. Terapiju bi trebalo početi u ranom uzrastu pre razvoja kontraktura jer se tada postižu bolji rezultati i može se sprečiti pojava deformiteta.
Danas se terapija tipom A botulinum toksina smatra farmakološkim sredstvom izbora u lečenju deformiteta kod pacijenata sa spastičnom formom cerebralne paralize zbog svog reverzibilnog efekta, niske stope neželjenih dejstava, bezbolnosti, kao i mogućnosti ponavljanja terapije.
Ključne reči: cerebralna paraliza, botulinum toksin, spastični deformitet, elektromioneurografija, skeletni mišić.
Reference
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