Botulinum toxin A in the management of focal muscle overactivity in children with cerebral palsy

Abstract

Cerebral palsy comprises a heterogenous group of neurological disorders representing a continuum of pathologies and clinical phenotypes. Although cerebral palsy is not a focal disorder, it is appropriate to treat identified focal problems as long as the intervention is goal directed. This paper reviews principles of managing muscle imbalance in the growing, changing child using a range of complementary, carefully timed intervention options. Over the past two decades these options have increasingly included intramuscular injection of botulinum toxin-A to manage focal spasticity and dystonia. The predictable movement patterns and postures characteristic of spasticity enable a systematic clinic..