title: Botulinum toxin type B improves the speed of reaching in children with cerebral palsy and arm dystonia: an open-label, dose-escalation pilot study.
abstract: Seven children between 2 and 15 years of age with cerebral palsy and upper extremity dystonia were enrolled in an open-label, dose-escalation pilot clinical trial of botulinum toxin type B (Myobloc), injected into the biceps and brachioradialis muscles of I or both arms. The primary outcome measure was the change in maximum speed of hand movement during attempted forward reaching. Escalating doses of 12.5, 25, and 50 U/kg per muscle were injected at each of 3 visits. Reaching speed improved in response to injection, and dystonia scores on the Burke-Fahn-Marsden dystonia scale, the Unified Dystonia Rating Scale, and the Unified Parkinson's Disease Rating Scale improved. There was not a dose-related effect on efficacy. There were no serious adverse events. Two children reported transient weakness. These results support the use of botulinum toxin type B as a safe and effective treatment for upper extremity dystonia in children with cerebral palsy. Larger controlled trials are needed to confirm these results.
authors.affiliation: Division of Child Neurology and Movement Disorders, Stanford University Medical Center, 300 Pasteur, Room A345, Stanford, CA 94305-5235, USA. sanger@stanford.edu
authors.forename: Terence D
authors.initials: TD
authors.lastname: Sanger
authors.forename: Sahana N
authors.initials: SN
authors.lastname: Kukke
authors.forename: Sara
authors.initials: S
authors.lastname: Sherman-Levine
mesh_terms: D000293:Adolescent; D001132:Arm / Q000503:physiopathology*; D001905:Botulinum Toxins / Q000627:therapeutic use*; D019274:Botulinum Toxins, Type A; D002547:Cerebral Palsy / Q000150:complications / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D002985:Clinical Protocols; D004305:Dose-Response Relationship, Drug; D020821:Dystonic Disorders / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D009068:Movement / Q000187:drug effects*; D009465:Neuromuscular Agents / Q000627:therapeutic use*; D010865:Pilot Projects; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D009465:Neuromuscular Agents; C096323:rimabotulinumtoxinB; D001905:Botulinum Toxins; D019274:Botulinum Toxins, Type A