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Botox and gait

Discussion in 'General Issues and Discussion Forum' started by Simon Spooner, Sep 6, 2011.

Tags:
  1. Admin2

    Admin2 Administrator Staff Member

    Related threads:
    Other threads tagged with botox
     
  2. timharmey

    timharmey Active Member

    I have seen botox injections used in kids with cerebal palsy to reduce muscle contracture, I sat in on a joint clinic with a paediatricin and a paediatric physio , the clinic ran on a regular basis
    Tim
     
  3. First research I was involved in after my PhD was looking at botox injections into the calf of children with CP.
     
  4. timharmey

    timharmey Active Member

    So could she just of had tightness in her flexor digatorum longus that could have been stretched out and the genitic link could be coincidience?
    Tim
     
  5. timharmey

    timharmey Active Member

    Is there any info out there on treating clawed toes due to neuralogical problems with botox.I am trying to go the xtra mile for one of my patients and all this talk has made me think that botox might have a place in this patients treatment
    tim
     
  6. blinda

    blinda MVP

    One of my pts has had a very successful course of botox therapy for fixed extended toes, following an intracerebral haemmorrhage. This was carried out at the Royal Leamington Spa Rehabilitation Hospital `botulinum toxin clionic`in their Feldon Ward.

    http://www.nhs.uk/Services/hospitals/Overview/DefaultView.aspx?id=30115

    Hope that helps!

    Cheers,
    Bel
     
  7. blinda

    blinda MVP

    Bit of time on my hands (in between patients and preparing our second eldest son for uni and my daughter for her driving test:eek:.....) so looked up my old uni references for dystonia management as I recalled one on botox;

    http://www.bmj.com/content/320/7228/161.full
     
  8. timharmey

    timharmey Active Member

    I was talking to the neuro physio and we have decided the patient I had in mind may not gain from botox , but it has been useful to explore the clinical reasoning and I will bear it in mind as a treatment option
    Tim
     
  9. Ninja11

    Ninja11 Active Member

    I recently spent some time down at the Royal Children's Hospital in Melbourne, and they were treating a child with CP/dystonia via ITB therapy. This involves surgical implant of an ITB pump under the skin in near the stomach. A catherter runs from the pump to the spinal fluid to deliver Baclofen, resulting in reduced spasticity. The pump had to be refilled approximately every 4mths, and doseage increased with age relative to increased muscle spascticity. The improvements in this child's gait and quality of life were very impressive. Botox is more site specific, compared to ITB therapy which can improve spasticity systemically.
     
  10. Having not heard of ITB therapy ( not my area ) found this Full text - http://www.turkishneurosurgery.org.tr/pdf/pdf_JTN_818.pdf

     
  11. Perthpod

    Perthpod Active Member

    That's fantastic! Does anyone know if this is common practice/Medicare covered in Australia?
     
  12. Ninja11

    Ninja11 Active Member

  13. Tuckersm

    Tuckersm Well-Known Member

    BoTox is covered by the PBS for certain conditions. Pretty much all CP kids, and upper limb adults.

    Otherwise about $450 per treatment for the BoTox, may be covered by private insurance, or a local public hospital program.

    And the giving of the injection, whether covered by PBS or not is covered by Medicare item 18360 and others with a scheduled fee of $120, with the abilityof a physician to also claim item 110 as well for the consultation associated with the injections.

    Within our health service we currently have 2 BoTox clinics, (both adult, one associated with Neurology and the other Rehab) and are trying to establish a third (CP Kids). Currently only a very limited number of "non-eligable" patients can access the service due to limited funding, restricting the ability to use it in adult patients with lower limb spasticity post CVA.
     
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