Author: Koman, AK et al.
Source: PEDIATRICS, volume 108, Number 5, November, 2001,
This study was done to look at how well botulinum toxin improves the walking of children with cerebral palsy and how safe it is to use. The calf muscles of 207 children with either hemiplegic or diplegic cerebral palsy were injected with botulinum toxin A (Botox ?) and the children were evaluated to look at its effects (good and bad). On average, every three months, each child received an injection dose of 4 units for every kilogram (2.2 pounds) they weighed. They were then evaluated to see if this improved their walking and to see if they had any side effects from the medicine. Some children also had their blood tested to see if they were developing any antibodies (a sign of resistance) to the medicine.
Seventy five percent (155) of the 207 children who started the study completed at least a year?s worth of injections. According to the authors, many (but not all) children showed improvement in their walking following Botox? injections and this improvement continued as long as they were getting their injections. The most common side effects caused by the medicine were increased stumbling, leg weakness, leg cramps, and decreased size of the muscles that were injected. In their discussion, the authors suggest that this medicine might best be used to provide ?a window of opportunity? to stretch tight muscles, strengthen weak muscles, improve the child?s ability to wear braces, and delay surgery to fix tight muscles and tendons.
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