title: Botulinum toxin type A in the treatment of lower-limb spasticity in children with cerebral palsy.
abstract: We evaluated the safety and effectiveness of botulinum toxin A (BoNT/A) in the treatment of spasticity in 20 children with spastic diplegic cerebral palsy (CP). All the patients received injections in the gastrocnemius and soleus, and 15 received injections in the adductors. The total dose varied from 70 to 140 U (99.75+/-16.26 U), or 7.45+/-2.06 U/kg per patient. The treatment improved the patients' walking and gait pattern significantly. There was also a significant alteration in the heel-ground distance and increased motion of the ankle joint. These structural changes in the feet were sustained until the end of the follow-up, although the same was not observed for the functional parameters. Three patients complained of weakness in the lower limbs. In conclusion, BoNT/A is safe and effective when used in a single session of injections and produces a sustained structural modification of the lower limbs. However, functional changes are temporary and are only observed during the peak effect of the drug.
authors.affiliation: Neurology Service, Department of Clinical Medicine, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brazil.
authors.forename: Carlos Henrique F
authors.initials: CH
authors.lastname: Camargo
authors.forename: Hélio A G
authors.initials: HA
authors.lastname: Teive
authors.forename: Marise
authors.initials: M
authors.lastname: Zonta
authors.forename: Gilmar C
authors.initials: GC
authors.lastname: Silva
authors.forename: Marcelo R
authors.initials: MR
authors.lastname: Oliveira
authors.forename: Maurício M
authors.initials: MM
authors.lastname: Roriz
authors.forename: Ivar V
authors.initials: IV
authors.lastname: Brandi
authors.forename: Nilson
authors.initials: N
authors.lastname: Becker
authors.forename: Rosana Hermínia
authors.initials: RH
authors.lastname: Scola
authors.forename: Lineu César
authors.initials: LC
authors.lastname: Werneck