Some Children Benefit from Being Injected with Poison

It's one of three cutting-edge ways used to relieve excessive muscle tone

November 23, 1999

Doctors at Children's Hospital at Strong have turned the tables on one of the most potent poisons known to man, using it to help children who have cerebral palsy, spinal cord damage, or traumatic brain injuries.

It's a paradox of modern medicine, but one that is working wonders. Children's Hospital is the only place in upstate New York using Botox (Botulinum Toxin) injections to treat youngsters with spasticity, a condition in which a child's muscles over-contract, causing stiff and awkward movements.

Botox injections are made with the toxin that causes botulism, a disease caused by eating food that is improperly canned. The toxin is extraordinarily potent and blocks the impulses that go from the nerves to the muscles, sometimes causing paralysis.

At Children's Hospital, the purified toxin is given in minute quantities, injected directly into the muscle, and is effective 90 percent of the time. Most children see improvement within 10 days, and injections are usually needed every three to six months.

"What's fascinating is that we're using a toxin that has plagued mankind for hundreds of years, and now we're able to use it to the benefit of these children," says Gregory Liptak, M.D., a pediatrician who works in the hospital's Kirch Developmental Services Center. "It's remarkably safe, because we're using incredibly small doses."

Botox injections - given to nearly 100 children here during the past year - are usually the first choice of doctors, but Children's Hospital this summer started offering two other techniques to help relieve spasticity in children. One involves implanting a Baclofen pump in a child's abdomen, under the skin. Baclofen is a drug that helps relieve excessive muscle tone.

"When you look at a child, it appears as if he or she swallowed a hockey puck," Liptak says, pointing out that the pump is battery-operated and controlled by several computer chips. "It's an excellent technology in that it can inject exact amounts of medication when needed."

A third way to treat spasticity is a procedure called Selective Dorsal Rhizotomy, which involves cutting nerves that come from the spinal cord in an effort to relieve excessive muscle tone. The latter two procedures are done by pediatric neurosurgeon, Jeffrey Campbell, M.D.

Liptak has been working in this field of medicine for 15 years, and says it is rewarding to see so much progress being made to help children. He's seen patients who had difficulty walking receive treatment that has allowed them to run.

"You have to carefully select the method to be used based on the child's size, age, and the areas of the body that are affected," Liptak says. "Part of the art of medicine is choosing the correct method."

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