Use of botulinum toxin in the preventive and palliative treatment of the hips in children with infantile cerebral palsy

Introduction. The bilateral spastic cerebral palsy (CP) usually produces hip abnormalities, already presents in many cases before 2 years of age, whose diagnostic requires X-ray because clinical exam do not detect some of them. The prognosis of CP hip disorders with conventional treatment is had, progressive, and limits the possibility of independent gait. Botulin toxin type A infiltrated in adductors, medial ischiotibials and iliopsoas, in addition to physiotherapy and orthosis, gives better results. Patients, methods and results. In our cases (98 cases, 193 hips) the natural evolution before (BT-A) treatment had been of progressive lateral migration of femoral head (86% got worse, and 11,4% became luxated), and after the onset of it the progression stopped in 74% of hips and reverted in other 14%. Conclusions. It is very important to start early the BT-A treatment and infiltrate systematically every 3-4 months in order to obtain good results. Stopping the treatment increase the chances of subluxation or luxation. BT-A is also a good treatment for hip pain in spastic CP.