Botulinum toxin has great role in meaning In the mechanism of action and the effects of botulinum toxin, a great many options are open for the medical experts. On this occasion we want to specify some aspects of this treatment in children with neurological injuries. Although the spasticity approach in adults and children shares specific characteristics, there are notable differences that are important to keep in mind. As we know, “children are not adults when they are little.”
Objectives Of Botulinum Toxin
Since the 1990s, botulinum toxin has been used to treat focal spasticity associated with cerebral palsy, becoming the drug of choice for dynamic contractures.
The goals we seek to infiltrate the spastic muscles vary according to the child’s global circumstances.
When we approach the lower limbs, we usually aim to:
In children who walk: achieve a more functional gait pattern (less expensive, less pain, more speed, and more physiological options)
In children as a whole: improve posture, facilitate hygiene,and prevent hip subluxation or dislocation.
For cerebral palsy in children, Upper limb infiltration in children is common but less frequent than lower limb infiltration. Generally, we will seek to facilitate movement and provide greater functionality.
Prevent, correct or stop deformities: prevent hip dislocation, knee flexion deformity, and equinus contracture
- Facilitate the learning of transfers, maintenance in standing, etc.
- Facilitate the activities of daily life or: dress, hygiene, etc.
- Relieve pain.
- Improve sitting posture in a chair or car.
How many doses of Botulinum Toxin do you usually use?
In children, the toxin doses used vary greatly, and are calculated based on:
- child weight
- muscle size
- infiltrated place
- degree of spasticity
- toxin type or brand
At what age do you usually start using Botulinum Toxin? The current trend is to start infiltration at an earlier age, to prevent the onset of fixed contractures and to start correct motor learning as soon as possible. In lower limbs, it is recommended to start the application in children from 1.5-5 years. The upper arm usually infiltrates after four years. But we utilize the application of plaster after botulinum toxin to increase the effect of botulinum toxin and to manage contracture. Post injection therapy & bracing should be good enough to have a long-lasting impact. With the latest medical report, we should botulinum toxin cautiously due to side effects of the permanent weakness of the muscle. So if it is really necessary then it should be used and repeated use should be stopped.
Trishla Foundation 