Perspectives: Specialty Pediatrics
Perspectives: Specialty Pediatrics

The Benefits Using Botox To Treat Pediatric Cerebral Palsy Patients

Posted on Aug 14, 2014 by JenFu Cheng, M.D., Section Chief, Physiatry

Botox use may typically be associated with adults trying to fend off signs of aging, but botulinum toxin has non-cosmetic uses as well, even in pediatrics and physiatry. Although there are numerous additional uses for Botox, the neurotoxin is especially helpful in treating patients with cerebral palsy here at Children’s Specialized Hospital.

It may be surprising to learn that botulinum toxin (Botox, Myobloc, Dysport, Xeomin) can be used to treat pediatric cerebral palsy patients, but the treatment is far from new. We have actually been treating cerebral palsy patients with Botox for well over 20 years.

Children with cerebral palsy often have muscle tightness due to increased (spasticity, dystonia). This makes it difficult for them to move and be positioned comfortably, and may increase the risk of orthopedic deformity. Injecting botulinum toxin into a muscle can relax the tightness for several months. Also, for kids with sialorrhea (drooling), botulinum toxin injections to the salivary glands can help decrease the secretions for several months.

Botulinum toxin injections can also be used in any condition where muscles are tight due to spasticity or dystonia. Common diagnoses include:

• Traumatic brain injury
• Stroke
• Spinal cord injury

At Children’s Specialized Hospital, we ensure that botulinum toxin injections are not used in isolation. Rather, they are used as part of a comprehensive program that includes other medications, therapies, bracing, casting and equipment.

We also utilize state-of-the-art guidance techniques, including electric stimulation and ultrasound, to make sure the medication is injected into the correct muscle and into the part of the muscle where it will be most effective. These techniques improve the results of the injections, as well as safety.

Additionally, we often combine botulinum toxin injections with alcohol nerve blocks, another injection technique that can relax spastic muscles. This allows us to relax many more muscles and larger muscles than with botulinum toxin injections alone.

Of course, some children tolerate injections better than others, so we offer many options to make the procedure easier for our young patients. The children may receive some anxiolysis and sedation to make them a little sleepy and less anxious, or they may be completely asleep for the procedure.

If you’re wondering whether Botox use is safe or appropriate with children, the data should reassure you. Safety and quality data shows no complications due to our anxiolysis for several years. Additionally, rates of side effects, including pain, are very low.

Have you used Botox with your patients and for which conditions? What has been your experience?

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