Affiliations: [a] Department of Rehabilitation and Regenerative Medicine, Columbia University Irving Medical Center, New York, NY, USA | [b] Department of Physiatry, Blythedale Children’s Hospital, Valhalla, NY, USA
Corresponding author: Heakyung Kim, Department of Rehabilitation and Regenerative Medicine, Columbia University Irving Medical Center, 180 Fort Washington Ave, HP-165, New York, NY, 10032, USA. Tel.: +1 212 305 5337; E-mail: [email protected].
Abstract: Recent studies have generally shown favorable outcomes for the use of botulinum toxin (BoNT) injections for the treatment of lower extremity spasticity in children with cerebral palsy. The randomized controlled trials and placebo trials are well described although even those and other studies show high variability in methodology for use of BoNT. This raises questions about which strategies are the most effective. In order to hone the technique, the aim of this review is to discuss these specific parameters: toxin type, dosing, series of injections, localization method, age, number of muscles, and troubleshooting poor outcomes.