Zerebralparesen und Botulinumtoxin

Zusammenfassung

Seit dem Erscheinen der interdisziplinären deutschen und europäischen Konsensus zum Thema Botulinumtoxin (BoNT) für Kinder mit Zerebraparese (CP) hat sich das fächerübergreifende, integrative Behandlungskonzept zur Förderung der motorischen Entwicklung zusehends etabliert. Neben der kondensierten tabellarischen Darstellung und Aktualisierung der Evidenz zu den wichtigsten Aspekten der Therapie, wurde 2009 eine grafische Darstellung der Therapieoptionen (Therapiekurven CP-Motorik) eingeführt. Diese grafische Darstellung der Therapieoptionen für die Förderung der motorischen Fertigkeiten bei Kindern mit CP ermöglicht eine strukturierte Beratung zu den Therapieoptionen und hat im Alltag seine Anwendertauglichkeit im Dialog mit den Familien bewiesen.

Insbesondere bei drei der zehn Domänen aus den Konsensus zur Behandlung mit BoNT haben sich neue Erkenntnisse ergeben: “therapeutische Anwendung/Versorgungsqualität”, “Sicherheit”, “Effekte der Botulinumtoxintherapie im Muskel”. Dieser Beitrag aus der Neuropädiatrie soll diese Punkte aus der klinischen Anwenderperspektive überprüfen und aus dem Blickwinkel der neu gewonnenen Erkenntnisse beleuchten.

Summary

Since the publication of the interdisciplinary German and European Consensus on Botulinum Toxin for Children with Cerebral Palsy, the integrative management to facilitate motor development has been further implemented into clinical care. In 2009 the updated consensus were published with an updated tabulated evidence report and for the first time including a graphical visualisation of the available treatment options for children across age and different severity levels of motor impairment (CP^Graph treatment modalities gross motor function). This graphical framework was meant to allow the multidisciplinary team to structure the counselling of patients, parents and additional involved specialists. Since then, it has proven to be very helpful in daily routine.

Within the last years new insights have evolved especially in three out of ten domains from the tabulated evidence consensus: “standards and quality of care”, “safety”, “effects of botulinum toxin within the muscle”. This report will focus on these aspects by interpreting the recently gained knowledge from a clinical perspective.

Schlüsselwörter

Zerebralparesen - multidisziplinäre Therapie - Therapiekurven CP-Motorik

Keywords

Cerebral palsy - interdisciplinary therapy - CP^Graph treatment modalities gross motor function

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