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Use of Botulinum Toxin Type A in Children With Cerebral Palsy

KW Nolan, PT, MS, PCS, is Associate Professor, Department of Physical Therapy, School of Health Science and Human Performance, Ithaca College–Rochester campus, 300 East River Rd, Rochester, NY 14623 (USA)
LL Cole, MS, RN, PNP, is Director, Kirch Developmental Services Center, Department of Pediatrics, University of Rochester Medical Center, Rochester, NY
GS Liptak, MD, MPH, is Professor of Pediatrics, Department of Pediatrics, University of Rochester Medical Center
Ms Nolan and Dr Liptak provided concept/idea/project design. All authors provided writing. Ms Cole and Dr Liptak provided consultation (including review of manuscript before submission)

(knolan@ithaca.edu). Address all correspondence to Ms Nolan

Submitted March 3, 2005; Accepted October 5, 2005

Key Words: Cerebral palsy • Drugs • Spasticity

Because this article has no abstract, we have provided an extract of the full text and any section headings.

	Introduction

 
Cerebral palsy is one of the most common causes of activity limitation in children. The central nervous system (CNS) lesion causing the disorder of posture and movement is nonprogressive, but the manifestations of the lesion may change over time. Children with cerebral palsy may display a range of movement disorders, alone or in combination, including dystonia, athetosis, ataxia, and spasticity.¹ Spasticity is a complex phenomenon and has been defined as "a motor disorder characterized by a velocity-dependent increase in tonic stretch reflexes (muscle tone) with exaggerated tendon jerks, resulting from hyperexcitability of the stretch reflex, as one component of the upper motoneuron syndrome."^2(p485) Spasticity can be associated with co-contraction, clonus, and hyperreflexia. Children with spastic cerebral palsy generally have a typical pattern of muscle weakness, impairment in selective motor control, and sensory impairment, in addition to spasticity.¹ In some centers, traditional management for children with spastic cerebral palsy has included . . . [Full Text of this Article]

	Pharmacology/Mechanism of Action

 

	Procedure/Protocol

 

	Patient Selection

 

	Effects/Outcomes

 
Spasticity Reduction

Range of Motion

Gross Motor Function

Gait

	Physical Therapists’ Role in Botulinum Toxin A Therapy

 
Current Limitations of Literature

	Conclusions

 

	Appendix

 

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