[Botulinum toxin type A in children: evaluation of indications with a review of the literature].
BACKGROUND
The aim of this study is to review the literature to indications of botulinum toxin type A in children.


METHODS
We review the international literature from 1990 to 2002 by querying the Pubmed database with the keywords "children" and "botulinum toxin".


RESULTS
Two hundred and forty-eight articles are retrieved. We selected the most relevant 64 articles among them. Several questions remain pending: which optimal dose, which periodicity for injections, which optimal age to prolong efficiency? The main criteria to estimate efficiency is functional ability improvement. No significant side effects are noted. The main use of botulinum toxin is the management of the spastic lower limb in cerebral palsy.


CONCLUSIONS
This review of the literature makes it possible to specify the interests and the operational limits of botulinum toxin in the child. Its effectiveness with the upper limb is not proven. The other indications remain to be studied in a more precise way.


CONCLUSIONS
This review shows many studies give the indications of botulinum toxin in children. The main indication is the lower limb spaticity in cerebral palsy. New prospective and double-blind studies should be performed with larger samples.
Bertrand
H
H
Service de chirurgie orthopédique, hôpital d'enfants Armand-Trousseau, 26, avenue du Docteur-A.-Netter, 75012 Paris, France.
Forin
V
V
D000293:Adolescent; D000367:Age Factors; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage / Q000494:pharmacology*; D002547:Cerebral Palsy / Q000150:complications / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D002986:Clinical Trials as Topic; D006801:Humans; D009128:Muscle Spasticity / Q000188:drug therapy* / Q000209:etiology; D009465:Neuromuscular Agents / Q000008:administration & dosage / Q000494:pharmacology*
D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A