title: A French observational study of botulinum toxin use in the management of children with cerebral palsy: BOTULOSCOPE.
abstract: BACKGROUND
  Dystonia and spasticity are common symptoms in children with Cerebral Palsy (CP), whose management is a challenge to overcome in order to enable the harmonized development of motor function during growth.
  
  
  OBJECTIVE
  To describe botulinum toxin A (BTX-A) use and efficacy as a treatment of focal spasticity in CP children in France.
  
  
  METHODS
  This prospective observational study included 282 CP children mostly administered according to French standards with BTX-A in lower limbs. Realistic therapeutic objectives were set with parents and children together before treatment initiation and assessed using the Visual Analogue Scale (VAS). Child management was recorded and the efficacy of injections was assessed during a 12-month follow-up period by physicians (Modified Ashworth Scale, joint range of motion, Physician Rating Scale, Gillette Functional Assessment Questionnaire and Gross Motor Function Measure-66) and by patients/parents (Visual Analogue Scale).
  
  
  RESULTS
  BTX-A treatment was administered in different muscle localizations at once and at doses higher than those recommended by the French Health Authorities. Children were treated in parallel by physiotherapy, casts and ortheses. Injections reduced spasticity and improved joint range of motion, gait pattern and movement capacity. Pain was reduced after injections. BTX-A administration was safe: no botulism-like case was reported. The log of injected children who were not included in the study suggested that a large population could benefit from BTX-A management.
  
  
  CONCLUSIONS
  We showed here the major input of BTX-A injections in the management of spasticity in CP children. The results are in favor of the use of BTX-A as conservative safe and efficient treatment of spasticity in children, which enables functional improvement as well as pain relief.
authors: Croix-rouge française - Centre Médico Chirurgical de Réadaptation des Massues, Lyon, France. chaleat-valayer.e@cmcr-massues.com
authors: Emmanuelle
authors: E
authors: Chaléat-Valayer
authors: Bernard
authors: B
authors: Parratte
authors: Cyrille
authors: C
authors: Colin
authors: Angélique
authors: A
authors: Denis
authors: Séverine
authors: S
authors: Oudin
authors: C
authors: C
authors: Bérard
authors: J C
authors: JC
authors: Bernard
authors: V
authors: V
authors: Bourg
authors: B
authors: B
authors: Deleplanque
authors: I
authors: I
authors: Dulieu
authors: P
authors: P
authors: Evrard
authors: P
authors: P
authors: Filipetti
authors: V
authors: V
authors: Flurin
authors: P
authors: P
authors: Gallien
authors: B
authors: B
authors: Héron-Long
authors: I
authors: I
authors: Hodgkinson
authors: I
authors: I
authors: Husson
authors: I
authors: I
authors: Jaisson-Hot
authors: E
authors: E
authors: Maupas
authors: F
authors: F
authors: Meurin
authors: G
authors: G
authors: Monnier
authors: D
authors: D
authors: Pérennou
authors: B
authors: B
authors: Pialoux
authors: V
authors: V
authors: Quentin
authors: M Simonetta
authors: MS
authors: Moreau
authors: M
authors: M
authors: Schneider
authors: Alain
authors: A
authors: Yelnik
authors: Philippe
authors: P
authors: Marque
mesh_terms: D000293:Adolescent; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage* / Q000009:adverse effects; D002547:Cerebral Palsy / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D005602:France; D006801:Humans; D007273:Injections, Intramuscular / Q000379:methods; D008297:Male; D009128:Muscle Spasticity / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D009465:Neuromuscular Agents / Q000008:administration & dosage* / Q000009:adverse effects; D011446:Prospective Studies
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A