Affiliations: Neurology Division, Children's Hospital of Michigan,
Wayne State University, School of Medicine, Detroit, Michigan, U.S.A. | Children's Research Center of Michigan, Children's
Hospital of Michigan, Wayne State University, School of Medicine, Detroit,
Michigan, U.S.A. | Wayne State University, School of Medicine, Detroit,
Michigan, U.S.A. | Oakwood Health Care System Dearborn, Michigan,
U.S.A.
Note: [] Correspondence: Yasser Awaad, M.D., MSc Associate Professor of
Pediatrics, Director of Pediatric Neurology and Movement Disorders, Oakwood
Healthcare System, University of Michigan, U.S.A. Office Address: 21031
Michigan Ave., Dearborn, MI 48124, U.S.A. Phone: (313) 791-4323, fax: (313)
791-4325. E-mail: [email protected]
Abstract: Cerebral palsy (CP) is a severely debilitating condition. The
underlying insult results in irreversible damage to the central nervous system,
treatment is essentially palliative. Botulinum toxin type-A (BTX/A)
Botox?Allergan, Inc. injections have been found to be effective palliation for
dynamic spasticity in CP. There is a paucity of data regarding the maximum dose
tolerated in the pediatric population. The present study examines the safety
and efficacy of BTX/A therapy at up to 40 U/kg. Twenty-two patients were
treated from 1995 to 1999. The population included four adults and 18 pediatric
patients. Patients were in three groups: diplegia (n=12), hemiplegia (n=5), and
quadriplegia (n=5). They were evaluated by the Modified Ashworth Scale. The
incidence and severity of complications is also reported. The significance of
these data is also commented upon. This study suggests that BTX/A therapy is
safe, efficacious, and cost effective at higher doses, and should be considered
as part of a comprehensive therapeutic regimen in appropriate candidates. (J
Pediatr Neurol 2004; 2(2): 91–96).
Keywords: botulinum toxin, cerebral palsy, spasticity, safety and efficacy
