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Utilisation de la toxine Botulinique dans le traitement de l'hypertonie déformante acquise du sujet âgé
Mémoire de Master / Thèse d'exercice   Open Access

Utilisation de la toxine Botulinique dans le traitement de l'hypertonie déformante acquise du sujet âgé

Sébastien Roussel
Masters , Université de Montpellier
07/10/2019

Résumé

Acquired Deforming Hypertonia Elderly subjects Botulinum toxin Pain Range of motion Spasticity Tolerance Efficacy Hypertonie déformante acquise Sujets âgés Toxine botulinique Douleur Amplitude articulaire Spasticité Tolérance Efficacité
The concept of acquired deforming Hypertonia (ADH) in the elderly subjects has recently been defined and expresses the neuro-orthopedic complications caused by all the of the elderly subject’s diseases responsible of reduced mobility. The medical literature on the use of botulinum toxin in this indication is almost non-existent. Objective: evaluation of the efficacy and tolerance of botulinum toxin injections in the HDA’s management. Materials and methods: monocentric retrospective study with data collection from the medical record systems allowing the inclusion of 47 patients over 80 years of age who have benefited from a control consultation, for a total of 67 injection sessions studied and performed by the same physician. Results: endpoints for efficacy and tolerance were multiple: mean rage of motion gain was: + 20, 97 ° (σ = 25, 36), mean spasticity decrease on the modified Ashworth Scale was: 0,89 (σ = 1, 22; p= 0,02), mean pain decrease at mobilization was 2.62 on the Algoplus scale (σ = 1, 53; p = 5, 6). Pain during injection returned to an Average figure of Algoplus at 0.95 (σ = 1, 09), and no serious systemic adverse effects were reported or found during the control consultation.Conclusion: the study is encouraging regarding the efficacy and tolerance of botulinum toxin injections in HDA in older subjects. It is necessary to make a prospective study with a personalized scale for the goals of care’s evaluation.

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