Use of botulinum toxin injection in 17 children with spastic cerebral palsy

The use of botulinum toxin was studied in 17 children with spastic cerebral palsy to determine its efficacy and tolerability. Eleven ambulatory and 6 nonambulatory patients were included. All children were undergoing a physiotherapy program with monitoring of their baseline states for 3 months before botulinum toxin injection. The effect was evident within 72 hours. The peak effect was noticed by 1 to 2 weeks in the majority; the effect lasted for 3 to 10 months. All children experienced decreased spasticity scores. Their functional status improved, with three nonambulatory children becoming ambulatory with assistance and five children with assisted ambulation becoming more independently ambulatory. Measurement of joint motion showed improvement in the range of motion as compared with baseline. Video analysis of the functional state in the nonambulatory or gait in the ambulatory children revealed improvement in all. The functional status of rising from the sitting position or standing demonstrated improvement. None of the children had any untoward side effects except mild transient pain at the injection site. This study demonstrated botulinum toxin is useful as an adjunctive therapy in ameliorating spasticity in children with cerebral palsy, especially in the younger ones. (C) 1998 by Elsevier Science Inc. All rights reserved.