Serebral Palside Spastisite Tedavisi

Gül Mete CİVELEK, (Ankara Çocuk Sağlığı ve Hastalıkları Hematoloji Onkoloji Eğitim ve Araştırma Hastanesi, Fiziksel Tıp ve Rehabilitasyon Kliniği, Ankara, Türkiye)
Ayçe ATALAY (Acıbadem Üniversitesi, Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı, İstanbul, Türkiye)
Güncel Pediatri
10 1
Yıl: 2016 Cilt: 14 Sayı: 3 Sayfa Aralığı: 136 - 141 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Serebral Palside Spastisite Tedavisi

Öz:
Serebral palsi tanısı klinik bir tanıdır ve motor gelişimde gerilik, anormal kas tonusu ve hiperrefleksiyi içerir. Serebral palsili çocuklarda kas güçsüzlüğü, spastisite, koordinasyon kaybı, primitif reflekslerin devam etmesi ve normal motor kontrolün gelişememesi sıklıkla görülür. Spastisite hıza bağımlı olarak, pasif kas gerilmesine karşı artan dirençtir. Spastisite derecesi ve etkileri açısından ayrıntılı olarak değerlendirildikten sonra bir tedavi programı oluşturulmalıdır. Optimal kas tonusuna ulaşabilmek için yapılacak tedaviler genel olarak fizik tedavi ve rehabilitasyon programını, oral ve enjekte edilen ilaçları ve cerrahi tedavileri kapsar. Serebral palside spastisite tedavisinde özellikle germe egzersizlerini içeren kişiselleştirilmiş bir fizik tedavi ve rehabilitasyon programı tedavi planlarında mutlaka yer almalıdır. Serebral palside spastisite tedavisi için verilen farmakoterapinin optimal uygulaması ile ilgili bir konsensus yoktur. Generalize spastisite tedavisinde baklofen, benzodiazepin, tizanidin ve dantrolen gibi oral ilaçlar kullanılabilir. Ağızdan alınan ilaçların sedasyon ve kognitif defisit gibi önemli yan etkileri vardır. Lokalize spastisite tedavisi için perinöral fenol ya da etil alkol enjeksiyonuyla kemodenervasyon ya da intramusküler botulinum nörotoksin A enjeksiyonu kullanılabilir. Botulinum nörotoksin tip A'nın çocuklarda spastisiteyi azaltmada güvenilir ve etkili olduğu gösterilmiştir. Serebral palside spastisite tedavisinde kullanılan cerrahi teknikler arasında en sık kullanılanı selektif dorsal rizotomidir ve seçili olgularda uygulanabilir. Bu derlemede serebral palside spastisite tedavisinde kullanılan tedavi seçenekleri yer almaktadır.
Anahtar Kelime:

Konular: Pediatri

Treatment of Spasticity in Cerebral Palsy

Öz:
The cerebral palsy diagnosis is a clinical one and it includes motor development delay, abnormal muscle tone and hyperreflexia. Muscle weakness, spasticity, loss of coordination, the continuation of the primitive reflexes and non-developed normal motor control are often seen in children with cerebral palsy. Spasticity is the velocity dependent increase in the resistance against passive muscle stretching. Spasticity treatment program should be established after detailed evaluation of degree and effects.Treatments to achieve optimal muscle tone include physical therapy and rehabilitation program, oral and injectable medications and surgical treatments. In the treatment of spasticity, a personalized physical therapy and rehabilitation program including stretching exercises should be in the treatment plans, absolutely. There is no consensus regarding the optimal application of pharmacotherapy for the treatment of spasticity in cerebral palsy. Oral medications such as baclofen, benzodiazepine, tizanidine and dantrolene can be used for the treatment of generalized spasticity. Oral drugs have significant side effects such as sedation and cognitive deficits. Chemodenervation with perineural phenol or ethanol injection or intramuscular injection of botulinum neurotoxin A can be used as treatment of localized spasticity. It is shown that botulinum neurotoxin type A is safe and effective in reducing spasticity in children. Most commonly used surgical technique for the treatment of spasticity in cerebral palsy is selective dorsal rhizotomy and it can be applied to selected cases. Treatment options that are used in the treatment of spasticity in cerebral palsy are discussed in this review.
Anahtar Kelime:

Konular: Pediatri
Belge Türü: Makale Makale Türü: Derleme Erişim Türü: Erişime Açık
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APA CİVELEK G, ATALAY A (2016). Serebral Palside Spastisite Tedavisi. , 136 - 141.
Chicago CİVELEK Gül Mete,ATALAY Ayçe Serebral Palside Spastisite Tedavisi. (2016): 136 - 141.
MLA CİVELEK Gül Mete,ATALAY Ayçe Serebral Palside Spastisite Tedavisi. , 2016, ss.136 - 141.
AMA CİVELEK G,ATALAY A Serebral Palside Spastisite Tedavisi. . 2016; 136 - 141.
Vancouver CİVELEK G,ATALAY A Serebral Palside Spastisite Tedavisi. . 2016; 136 - 141.
IEEE CİVELEK G,ATALAY A "Serebral Palside Spastisite Tedavisi." , ss.136 - 141, 2016.
ISNAD CİVELEK, Gül Mete - ATALAY, Ayçe. "Serebral Palside Spastisite Tedavisi". (2016), 136-141.
APA CİVELEK G, ATALAY A (2016). Serebral Palside Spastisite Tedavisi. Güncel Pediatri, 14(3), 136 - 141.
Chicago CİVELEK Gül Mete,ATALAY Ayçe Serebral Palside Spastisite Tedavisi. Güncel Pediatri 14, no.3 (2016): 136 - 141.
MLA CİVELEK Gül Mete,ATALAY Ayçe Serebral Palside Spastisite Tedavisi. Güncel Pediatri, vol.14, no.3, 2016, ss.136 - 141.
AMA CİVELEK G,ATALAY A Serebral Palside Spastisite Tedavisi. Güncel Pediatri. 2016; 14(3): 136 - 141.
Vancouver CİVELEK G,ATALAY A Serebral Palside Spastisite Tedavisi. Güncel Pediatri. 2016; 14(3): 136 - 141.
IEEE CİVELEK G,ATALAY A "Serebral Palside Spastisite Tedavisi." Güncel Pediatri, 14, ss.136 - 141, 2016.
ISNAD CİVELEK, Gül Mete - ATALAY, Ayçe. "Serebral Palside Spastisite Tedavisi". Güncel Pediatri 14/3 (2016), 136-141.
Sayfa Oluşturulma Tarihi
17-04-2024 5:59

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