Botulinum toxin A in the treatment of spasticity caused by infantile cerebral palsy

The authors present a review of contemporary knowledge on the possibilities of treating infantile spasticity by botulinum toxin A. They deal in detail with the problem of indication of treatment with botulinum toxin A and the position of this treatment among other therapeutic possibilities. The authors summarize hitherto assembled knowledge on the pathophysiological basis of the action of botulotoxin in spasticity and in dyskinesias characterized by muscular hypertonia and mention hitherto published theories on the possible long-term effect of botulotoxin A. They submit a proposal of indication criteria of treatment of patients with infantile cerebral palsy by botulotoxin and suggestions for evaluation of the effect by clinical scales, kinesiological examination and (perspectively), by means of a comprehensive analysis of walking.