Botulinum toxin in the treatment of cerebral palsy.

This paper reports the results of botulinum toxin A treatment in 13 children with cerebral palsy. All patients except one exhibited dynamic deformities in one hand or foot and changes in muscle tone of corticospinal and extrapyramidal origin. The primary purpose of the treatment was to improve the impaired skilled movements which resulted from dystonic limb posture and were the most disabling symptoms in the group studied. The study showed that the botulinum toxin treatment produced a significant improvement in functional disability in terms of amelioration of skilled hand movements and foot posture (p < 0.01). The injections took effect a few days after dystonic muscle infiltration, and the mean duration of improvement was 3.1 months (2.0-4.0 months). Side effects were negligible and transient; transitory muscle weakness was the most frequent. Botulinum toxin A provides a safe and effective adjuvant treatment of dystonic skilled movements and gait disorders in children with cerebral palsy.