Arch Dis Child 99:392-394 doi:10.1136/archdischild-2013-305805
  • Archimedes

Question 2: Is there any long-term benefit from injecting botulinum toxin-A into children with cerebral palsy?

  1. James S Huntley
  1. Royal Hospital for Sick Children Glasgow, Glasgow, UK
  1. Correspondence to Lyndon J Bradley, Royal Hospital for Sick Children Glasgow, Glasgow G3 8SJ, UK;
  • Received 7 December 2013
  • Accepted 16 December 2013

Clinical scenario

A 5-year-old girl with diplegic cerebral palsy has been seen regularly since the age of 3 years. As part of the management for lower limb spasticity, she has undergone three previous intramuscular botulinum toxin A injections (BoTN-A) to her gastrocnemii. During the consent process for a further injection, the mother asks if this treatment will be of benefit to her daughter in the future.

Clinical question

In children with cerebral palsy receiving intramuscular injection of BoTN-A is there any clinically relevant long-term (greater than 1 year) effect?


A literature search was performed in January 2013 using MEDLINE, PubMed and the Cochrane Database (table 1). The population identifier of ‘cerebral palsy’ and intervention of either botulinum toxin(s), Botulinum, BoNT-A, BoNT-B, BtA, BtB, BT, Botox or Dysport was used, limited to English language, from the year 1993 and the age limit of child (0–18 years) (N=2159). This was then restricted to ‘randomised controlled trials’ (N=58). These were …