Botulinum toxin treatment in upper limb spasticity: treatment consistency

Area of Science:

• Pediatric Neurology
• Rehabilitation Medicine
• Movement Disorders

Background:

• Botulinum toxin injections are a common treatment for spasticity in children with cerebral palsy.
• Understanding treatment consistency is crucial for optimizing long-term management and outcomes.
• Pragmatic, real-world data on botulinum toxin administration in pediatric spasticity is limited.

Purpose of the Study:

• To assess the treatment consistency of botulinum toxin (Botox and Dysport) administration in children with spastic upper limbs.
• To evaluate the stability of dosages and injection intervals in a pragmatic clinical setting over an 8-year period.

Main Methods:

• A retrospective analysis of 153 children (81 with bilateral, 72 with unilateral cerebral palsy) treated over 8 years.
• Botulinum toxin dosages and injection intervals were analyzed, with treatment response assessed at 3, 6, and 12 months.
• Mixed-effects models were used to determine the stability of dosage and time intervals between injections.

Main Results:

• Botulinum toxin dosage remained stable across subsequent treatment visits (p = 0.144).
• The time intervals between injections were also consistent over time (p = 0.279).
• Children older than 4 years at initial treatment had significantly longer intervals between sessions (p = 0.010).

Conclusions:

• Botulinum toxin administration for spastic upper limbs in children demonstrates notable consistency in dosage and injection timing under pragmatic conditions.
• The findings support the reliability of botulinum toxin as a long-term therapeutic option for managing pediatric spasticity.
• Treatment intervals may be influenced by patient age, suggesting potential for individualized treatment protocols.