title: [Selection of a dose of the botulinum toxin A in spastic forms of cerebral palsy].
abstract: OBJECTIVE
  To analyze the efficacy and safety of dose ranges of abobotulinum toxin A (BTA) for multilevel injections into upper and lower extremity muscles in children with spastic forms of cerebral palsy (CP).
  
  
  METHODS
  We analyzed retrospectively multilevel BTA injections for 216 patients, aged from 2 to 17 years. Children received 1-6 repeated injections and complex physiotherapy. Patients were classified according to the GMFCS. Treatment results were evaluated with the modified Ashworth and Tardieu scales.
  
  
  RESULTS
  Multilevel BTA injections were indicated for the most (89/8%) of the patients with spastic forms of CP, and in most of them the total dosage exceeded 30 U/kg. In the bilateral forms of CP, the total dosage (U and U/kg) was higher compared to the unilateral forms. Doses for each muscle in U/kg were similar in all CP forms. The total doses of BTA and the intervals between the repeated injections were stable for each patient.
  
  
  CONCLUSIONS
  The dose ranges suggested for CP are effective and safe for the reduction of spasticity in several functional segments of upper and lower extremities in one treatment session.
authors.affiliation: Research Centre of Children's Health, Moscow.
authors.forename: A L
authors.initials: AL
authors.lastname: Kurenkov
authors.affiliation: Research Centre of Children's Health, Moscow.
authors.forename: O A
authors.initials: OA
authors.lastname: Klochkova
authors.affiliation: Research Centre of Children's Health, Moscow.
authors.forename: Kh M
authors.initials: KM
authors.lastname: Karimova
authors.affiliation: Research Centre of Children's Health, Moscow.
authors.forename: B I
authors.initials: BI
authors.lastname: Bursagova
authors.affiliation: Research Centre of Children's Health, Moscow; Sechenov First Moscow Medical State University, Moscow; Pirogov Russian National Research Medical University, Moscow.
authors.forename: L S
authors.initials: LS
authors.lastname: Namazova-Baranova
authors.affiliation: Research Centre of Children's Health, Moscow.
authors.forename: L M
authors.initials: LM
authors.lastname: Kuzenkova
authors.affiliation: Research Centre of Children's Health, Moscow.
authors.forename: A M
authors.initials: AM
authors.lastname: Mamedyarov
authors.affiliation: Sechenov First Moscow Medical State University, Moscow.
authors.forename: A R
authors.initials: AR
authors.lastname: Artemenko
authors.affiliation: Research Centre of Children's Health, Moscow.
authors.forename: S A
authors.initials: SA
authors.lastname: Petrova