title: The key-muscle concept: a long-term low-dose injection strategy for botulinum toxin A treatment in cerebral palsy.
abstract: Botulinum toxin (BoNT) is a well established treatment in cerebral palsy. A uniform dose strategy is, however, missing. We reviewed 35 children with spastic cerebral palsy treated with BoNT according to a newly-developed Key-Muscle concept. All patients received at least 4 BoNT treatments. Systemic side effects or secondary non-response were not observed. After a mean follow-up of 303 months, none of these patients needed bone surgery whereas 6 underwent soft tissue procedures. The Key-Muscle concept is a safe and effective treatment in spastic cerebral palsy. It respects the need for long-term therapy during motor development. Contractures and lever arm disease can be avoided.
authors.affiliation: Center for Musculoskeletal Surgery, Charite--Universitätsmedizin Berlin, Germany.
authors.forename: Richard
authors.initials: R
authors.lastname: Placzek
authors.forename: Khaled Hamed
authors.initials: KH
authors.lastname: Salem
authors.forename: Ludwig A
authors.initials: LA
authors.lastname: Meiss
authors.forename: Dagmar
authors.initials: D
authors.lastname: Siebold
authors.forename: Wolf
authors.initials: W
authors.lastname: Drescher
mesh_terms: D019274:Botulinum Toxins, Type A / Q000008:administration & dosage*; D002547:Cerebral Palsy / Q000188:drug therapy; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007273:Injections, Intramuscular / Q000379:methods; D008297:Male; D009465:Neuromuscular Agents / Q000008:administration & dosage*; D012189:Retrospective Studies
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A; C542869:abobotulinumtoxinA