The Use of Botox Injection to Treat Cerebral Palsy in Children

Background: Cerebral Palsy is the most common neuromuscular disability in children. It is a group of permanent disorders related to development of movement and posture that occurs in the infant's brain. Cerebral Palsy results in spascitiy, along with many different abnormalities such as visual impairment, hearing loss salivation and speech problems. Although, these symptoms were previously treated by surgical intervention, during the recent years Botulinum Toxin A (BTXA) has gained popularity and acceptance from FDA and proved to a more superior approach in treatment of cerebral palsy when applied through a multilevel integrated approach. Objective: To understand the mechanism of action of BXA, to find out the recommended age, dose and technique and evaluate the advantages and disadvantages of BTXA. Methodology: A literature review of more than 60 articles that were classified into 20 literature review, 20 RCT and others case control or cohort studies using a medical engine (Pubmed) were analyzed, organized and summarized. Results: Many studies have recommended earlier intervention for treatment of children with BTXA as children with younger age (2-6 years) show better response as their motion and gait patterns are still flexible. Furthermore, no technique or dose has proven to be more effective in treatment of cerebral palsy, even though literature shows the short life of BTXA (3 months) more established studies have found that repeated injections (up to 3 injections) have shown to increase the quality of life and gross motor function of these children up to 18 months after their injection. Conclusion: BTXA injections have proven to be effective in improving the gross motor function and quality of life of children with Cerebral Palsy. Also, BTXA injections have shown to be effective in treating dental symptoms of children with CP such as sialorrhea. The recommended approach for BTXA injections is a multilevel approach this can be done by combining the injections with conservative therapies such as physiotherapy, orthodontic management or casts. All adverse events associated with BTXA have been rated mild to moderate; no severe effects were reported.