Botulinum toxin type A and dynamic equinus in children with cerebral palsy: new indication. Better than repeat casts

(1) Botox degrees , a product based on type A botulinum toxin, has received a new licensed indication in the local treatment of dynamic equinus in children with spasticity due to cerebral palsy. (2) Three placebo-controlled trials show that intramuscular injections of type A botulinum toxin reduce spastic equinus and substantially improve walking for at least 3 months. Two small trials, each involving 20 children, show no difference in effects between type A botulinum toxin and successive stretching casts. (3) In this setting the risk of adverse effects is smaller with type A botulinum toxin than with stretching casts. (4) Treatment with type A botulinum toxin is costly.