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The Use of Botulinum Toxin in the Management of Cerebral Palsy in Pediatric Patients

  • L. Andrew Koman
  • James F. MooneyIII
  • Beth P. Smith

Abstract

The intramuscular use of botulinum toxin (Botox) for the purpose of neuromuscular blockade is accepted therapy for certain ocular and facial muscular imbalances, and its mechanism of action has been well described.1–15 The therapeutic use of Botox in larger skeletal muscle groups is not as well established. Direct intramuscular injections of Botox into the stemocleidomastoid, trapezius, and splenii muscles have resulted in clinical improvement in spasmodic torticollis;16,17 preliminary studies using Botox to treat focal foot and hand dystonias, upper limb spasticity in stroke patients, and spastic adductor muscles in patients with multiple sclerosis have been reported.4,5,18 Until recently, however, there have been no reports of Botox being used to manage the spasticity of cerebral palsy. Before discussing the use of Botox in this population, it is important to present a general overview of the pathophysiology of cerebral palsy and to point out the large number of patients with this disorder.

Keywords

Cerebral Palsy Botulinum Toxin Botulinum Toxin Injection Hemifacial Spasm Focal Dystonia 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer Science+Business Media New York 1993

Authors and Affiliations

  • L. Andrew Koman
    • 1
  • James F. MooneyIII
  • Beth P. Smith
    • 1
  1. 1.Department of Orthopaedic Surgery, The Bowman Gray School of MedicineWake Forest UniversityWinston-SalemUSA

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