Ataxia - National Ataxia Foundation (NFA)
Autism - Autism Society
Brain Injury - Brain Injury Association Inc. – Brain Trauma Foundation
Brain Tumor – American Brain Tumor Association (ABTA) – National Brain Tumor Foundation – Children’s Brain Tumor Foundation
Cerebral Palsy – United Cerebral Palsy
Cerebral Palsy patient information from the American Academy of Neurology
Brain Injury Brain Injury Association Inc. - Brain Trauma Foundation
ADDITIONAL RESOURCES:
Botox Program - adapted from Kennedy Krieger Institute Here
Children, adolescents & adults with limited functional range of motion due to spasticity or dystonia are evaluated and treated with botulinum toxin when appropriate. An intervention plan is designed to address the specific needs of each patient in collaboration with the family and the patient's therapists.
The appropriate patient is one who has a clearly identified muscle or group of muscles that interferes with progress in therapy or that makes caring for the patient more difficult. Examples include tight hip muscles that put the patient at risk for hip dislocation or tight elbow muscles that make reaching more difficult. There are many other circumstances in which botulinum toxin is useful and these can be addressed on a case by case basis.
Botulinum toxin is manufactured under the trade names. Although the medicine is made from the same substance that causes food poisoning, it is very safe and almost no serious adverse effects have been reported following its administration in the vast majority of cases. The effect is temporary and usually lasts between three to six months.
The treatment is given by intramuscular injection and is likely to be anxiety producing for the patient. The following recommendations can lessen the discomfort of the procedure:
- A cream or vapo-coolant spray to numb the skin surface can be placed on the injection sites.
- Music, a favorite blanket, or any item that is normally comforting to the patient are welcome.
The discomfort involved is approximately the same as the discomfort associated with immunizations. Unlike immunizations, there is usually no swelling or aching at the injection site. Children can return to their normal activities.
You may begin to see results 24 hours after the injection, but usually not for two or three days. Maximum effects are seen between one and two weeks after the injection and will probably last for several months. A follow up appointment to measure the effects of intervention is scheduled when feasible and appropriate.
Examples of possible changes include improved range of motion, greater ease in stretching, improved tolerance to wearing braces, developmental gains (e.g., crawling, standing) or specific gait changes. Every patient is different and outcomes will vary. When the treatment begins to wear off, you should discuss with your doctor whether repeated injections are the appropriate treatment in achieving your therapeutic goals.
An effective treatment is almost always associated with an ongoing therapy program that builds upon the relaxation in tone. Therefore, physical or occupational therapy should be arranged before the treatment. It is often helpful to have the patient's therapists contact the treating physician before the treatment so they can discuss the treatment goals.
PRIMARY GOALS:
The primary goal is to improve the functional range of motion through focal relaxation of targeted muscles using injections of botulinum toxin. Specific goals may include the following:
- Improve gait
- Improve upper extremity function
- Prevent deformity
- Improve positioning
- Delay surgical intervention
- Decrease pain
- Improve tolerance of splints
- Improve hygiene
- Decrease burden of care
OUR SUCCESS:
Dr. Rotenberg has used this modality for treatment over 10 years. Hundreds of patients have been treated. Dr. Rotenberg serves patients in the Houston medical Center, Memorial City and San Antonio.
Dr. Rotenberg administers botox with conscious sedation or under anesthesia in San Antonio and Houston.
CONTACTS:
To make a referral or request an initial evaluation:
Call our office for an appointment 713-464-4107.
PRIMARY DIAGNOSES SERVED:
ADDITIONAL DIAGNOSES SERVED:
Congenital diplegia
Congenital quadriplegia
Dystonia
Neurological disorders
Spastic hemiplegia
Spasticity
Abnormal muscle tone
Limited joint movement
MIGRAINE
DYSTONIAS
HYPERHIDROSIS (EXCESS SWEATING)
