A Case Report of Cryoneurolysis With Factor VIII Administration for Cerebral Palsy-related Spasticity in a Patient With Hemophilia A.
Abstract
Spasticity affects up to 80% of individuals with cerebral palsy and can lead to pain and difficulties with performing activities of daily living. If left untreated, spasticity can progress to contracture and neuro-orthopedic deformities. Cryoneurolysis is an emerging and mini-invasive ultrasound-guided technique that causes secondary axonotmesis of peripheral nerves through the formation of an ice ball and may result in months to years of improved range of motion and reduced pain in patients with spasticity. However, the safety of cryoneurolysis has not yet been established in patients with an increased bleeding risk secondary to Hemophilia A. We present a case of cryoneurolysis for cerebral palsy-related spasticity in a 14-year-old male with hemophilia A who previously had minimal benefit from botulinum toxin for increased elbow and wrist flexor tone with contracture. Fifteen minutes prior to cryoneurolysis, an IV infusion of 2000 IU of recombinant antihemophilic factor (FVIII) was administered for bleeding prophylaxis. Targets were identified with ultrasound guidance and nerve stimulation and cryoneurolysis was performed without bleeding complications or adverse events. There was an immediate improvement in tone and range of motion that was maintained at 3- and 8-month follow-ups with reported increased left arm function. This case suggests that cryoneurolysis is an effective mini-invasive procedure for spasticity that improves tone and range of motion and is safe for use in patients with Hemophilia A who receive adequate Factor VIII prophylaxis.
추출된 의학 개체 (NER)
| 유형 | 영어 표현 | 한국어 / 풀이 | UMLS CUI | 출처 | 등장 |
|---|---|---|---|---|---|
| 시술 | botulinum toxin
|
보툴리눔독소 주사 | dict | 1 | |
| 해부 | Cerebral
|
scispacy | 1 | ||
| 해부 | elbow
|
scispacy | 1 | ||
| 해부 | nerve
|
scispacy | 1 | ||
| 질환 | Spasticity
|
C0026838
Muscle Spasticity
|
scispacy | 1 | |
| 질환 | A. Spasticity
|
C0026838
Muscle Spasticity
|
scispacy | 1 | |
| 질환 | cerebral palsy
|
C0007789
Cerebral Palsy
|
scispacy | 1 | |
| 질환 | pain
|
C0030193
Pain
|
scispacy | 1 | |
| 질환 | contracture
|
C0009917
Contracture
|
scispacy | 1 | |
| 질환 | neuro-orthopedic deformities
|
scispacy | 1 | ||
| 질환 | axonotmesis
|
C0476201
Axonotmesis
|
scispacy | 1 | |
| 질환 | bleeding
|
C0019080
Hemorrhage
|
scispacy | 1 | |
| 질환 | cerebral palsy-related spasticity
|
scispacy | 1 | ||
| 질환 | hemophilia A
|
C0019069
Hemophilia A
|
scispacy | 1 | |
| 질환 | Hemophilia A.
|
scispacy | 1 | ||
| 기타 | Factor VIII
|
scispacy | 1 | ||
| 기타 | Patient
|
scispacy | 1 | ||
| 기타 | peripheral nerves
|
scispacy | 1 | ||
| 기타 | patients
|
scispacy | 1 | ||
| 기타 | male
|
scispacy | 1 | ||
| 기타 | FVIII
|
scispacy | 1 | ||
| 기타 | left arm
|
scispacy | 1 |
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