Toxina botulínica no tratamento de estrabismo horizontal em crianças com paralisia cerebral

• Autor(a) principal: Cronemberger, Monica Fialho [UNIFESP]
• Data de Publicação: 2006
• Outros Autores: Mendonça, Tomás Scalamandré [UNIFESP], Bicas, Harley Edison do Amaral [UNIFESP]
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Repositório Institucional da UNIFESP
• dARK ID: ark:/48912/001300000kphv
• DOI: 10.1590/S0004-27492006000400013
• Texto Completo: http://dx.doi.org/10.1590/S0004-27492006000400013; http://repositorio.unifesp.br/handle/11600/3168
• topic: Botulinum toxin type A; Strabismus; Cerebral palsy; Oculomotor muscles; Esotropia; Blepharoptosis; Toxina botulínica tipo A; Estrabismo; Paralisia cerebral; Músculos oculomotores; Esotropia; Blefaroptose

To evaluate the efficacy of botulinum toxin injection in the treatment of horizontal strabismus in children with cerebral palsy. METHODS: A group of 24 patients, age 6 - 156 months, with cerebral palsy and horizontal strabismus (17 esotropias ranging from 25 to 45 PD and 7 exotropias ranging from 20 to 45 PD) were treated with botulinum toxin (34 medial rectus and 14 lateral rectus muscles). The children underwent full ophthalmic examination. The injection treatment was performed after sedation using Mendonça's forceps. The follow-up was done after 7 days, 15 days and monthly. Deviation less or equal of 10 PD after 6 months of follow-up was considered successful. However, if patients did not achieve this result a second application could be performed. RESULTS: In the group of esotropia (n=17) 47.1% had successful results with only one application after two years of follow-up. All of these patients had previous deviation less than or equal to 35 PD. In the exotropia group a single injection was not sufficient to achieve successful result. The side effects included: subconjutival hemorrhage in 4 (16.7%) patients, transient vertical deviation in 4 (16.7%) and transient ptosis in 22 (91.7%). CONCLUSION: The use of botulinum toxin was a good alternative in the treatment of children with cerebral palsy and esotropia.