title: Botulinum toxin type A injection for management of upper limb spasticity in children with cerebral palsy: a literature review.
abstract: The aim of this article was to present a review of the research literature on the outcome of botulinum toxin type A (BTX-A) injection for management of upper limb spasticity in children with cerebral palsy (CP). We searched the electronic databases of MEDLINE, CINAHL and PUBMED for all published studies with full-length English text available. For each study, the quality of the methods and the strength of evidence were assessed by 2 independent reviewers based on the American Academy for Cerebral Palsy and Developmental Medicine (AACPDM) guidelines. Four studies of level I, 8 studies of level IV and 4 studies of level V were identified. Due to the limited number of studies with high quality evidence and inconsistent results among studies, we were unable to support or refute the usefulness of BTX-A injection for management of upper limb spasticity in children with CP. Moreover, we identified several variables that may affect the outcome of injection, such as timing of age, dosage, dilution volumes, localization techniques of target muscles and participant characteristics. In summary, we have presented a review the literature and a discussion of the considerable uncertainty and variation associated with the clinical use of BTX-A injection for management of upper limb spasticity in children with CP.
authors.affiliation: Rehabilitation Hospital, Yonsei University College of Medicine, 134 Shinchon- dong, Seodaemun-gu, Seoul 120-752, Korea. pes1234@yumc.yonsei.ac.kr
authors.forename: Eun Sook
authors.initials: ES
authors.lastname: Park
authors.forename: Dong-Wook
authors.initials: DW
authors.lastname: Rha
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage / Q000627:therapeutic use*; D002547:Cerebral Palsy / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D007267:Injections; D009128:Muscle Spasticity / Q000188:drug therapy; D009465:Neuromuscular Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D016059:Range of Motion, Articular / Q000187:drug effects; D034941:Upper Extremity
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A