Elsevier

Pediatric Neurology

Volume 10, Issue 4, June 1994, Pages 284-288
Pediatric Neurology

Original article
Botulinum toxin a in management of cerebral palsy

https://doi.org/10.1016/0887-8994(94)90123-6Get rights and content

Abstract

The efficacy of local injection of botulinum toxin A in selected skeletal muscles to relieve muscle hypertonia and muscle contracture, and increase range of motion in children with cerebral palsy was studied in an open ABA (baseline-treatment-posttreatment phase) type of study. The first 6 months were the baseline phase, the day of injection the treatment phase, and the next 6 months the posttreatment phase. The patients acted as their own controls. Fifteen children with cerebral palsy (mean age: 6 years, 8 months) were included in the study. All had limb deformities associated with nonfixed joint contractures that had not responded to physical therapy. Clinical assessment of passive and active muscle tone was performed using a modified Ashworth scale. The range of motion to passive movement was measured with a manual goniometer. Botulinum toxin was injected directly into the muscle at several sites. The postinjection scores of muscle hypertonia were significantly lower (P < .01) and the range-of-motion values demonstrated a significant increase (P < .001). Functional improvement was measured by decreased scissoring on standing in all 6 children with adductor muscles injected; all 6 children with knee flexor muscles injected were able to straighten the knees. The 3 children with injected gastrocnemius muscles were able to achieve heel-strike while barefooted. The study provides evidence that the intramuscular injection of botulinum toxin A in selected skeletal muscles decreases muscle tone and contractures, and increases range of motion and motor function.

References (16)

  • American Academy of Neurology

    Assessment: The clinical usefulness of botulinum toxin-A in treating neurologic disorders

  • American Academy of Otolaryngology

    Head and neck surgery policy statement: Botox for spasmodic dysphonia

    AAO-HNS Bull

    (1990)
  • Institutes of Health Consensus Developmental Conference National

    Consensus statement

  • GE Borodic et al.

    Blepharospasm and its treatment with emphasis on the use of botulinum toxin

    Plast Reconstr Surg

    (1989)
  • AP Cosgrove et al.

    Botulinum toxin-A prevents the development of contracture in the hereditary spastic mouse

    Dev Med Child Neurol

    (1992)
  • LA Koman et al.

    Management of cerebral palsy with botulinum toxin: A randomized double-blind study

    Dev Med Child Neurol

    (1992)
  • I Ziv et al.

    Muscle growth in normal and spastic mice

    Dev Med Child Neurol

    (1984)
  • NJ O'Dwyer et al.

    Mechanisms of muscles growth related to muscle contracture in cerebral palsy

    Dev Med Child Neurol

    (1989)
There are more references available in the full text version of this article.

Cited by (0)

View full text