Botulinum toxin A as an adjunct to treatment in the management of the upper limb in children with spastic cerebral palsy

Botulinum toxin-A (BoNT-A ) is effective as an adjunct to occupational therapy compared to occupational therapy alone in managing the upper limb in children with spastic cerebral palsy, but BoNT-A alone appears not to be effective.

A Cochrane review included 10 studies with a total of 397 subjects. Concentration of Botulinum toxin-A (BoNT-A) ranged from 50U/1.0ml to 200U/1.0ml saline with doses of 0.5U to 16U/kg body weight and total doses of 220 to 410 Units (Botox®). BoNT-A as an adjunct to occupational therapy in managing the upper limb in children with spastic cerebral palsy was more effective than occupational therapy alone in reducing impairment, improving activity level outcomes and goal achievement, but not for improving quality of life or perceived self-competence. When compared with placebo or no treatment, BoNT-A alone was not effective.

Ədəbiyyat

1. Hoare BJ, Wallen MA, Imms C, Villanueva E, Rawicki HB, Carey L. Botulinum toxin A as an adjunct to treatment in the management of the upper limb in children with spastic cerebral palsy (UPDATE). Cochrane Database Syst Rev 2010;(1):CD003469.