Upper Limb Onabotulinumtoxin A Injections in Children Under 2 Years with Cerebral Palsy: A Retrospective Chart Review
Danni Centorame1, Barry Rawicki1,2, Sabine Hennel1,2
1Department of Paediatrics, 2541Monash University, Clayton, Australia.
Insights
Onabotulinumtoxin A (OnaA) injections are safe for managing upper limb spasticity in young children with cerebral palsy. This treatment should complement standard evidence-based therapies for optimal outcomes.
Area of Science:
- Pediatric Neurology
- Rehabilitation Medicine
- Movement Disorders
Background:
- Cerebral palsy (CP) frequently causes upper limb impairment in children.
- Early intervention is crucial for managing motor deficits in infants with CP.
- Onabotulinumtoxin A (OnaA) is used to treat focal muscle overactivity.
Purpose of the Study:
- To evaluate the safety and efficacy of OnaA for upper limb spasticity in children under two years old with cerebral palsy.
- To describe a clinical care model for managing upper limb impairment in this population.
Main Methods:
- A retrospective chart audit was conducted on 65 infants (13-23 months) who received upper limb OnaA injections.
- Data collected included administration procedures, muscle selection trends, and adverse events.
- The study examined treatment patterns over a specific period.
Main Results:
- Adverse events were reported in only 6% of the treated infants.
- Muscles controlling thumb and forearm movements were most frequently targeted.
- There was an observed increase in injections targeting the subscapularis and flexor digitorum profundus muscles.
Conclusions:
- Onabotulinumtoxin A (OnaA) demonstrates a favorable safety profile for short-term management of upper limb overactivity in infants with cerebral palsy.
- OnaA should be integrated as an adjunctive therapy alongside established evidence-based treatments.
- The findings support the use of OnaA in a proactive clinical management model for pediatric cerebral palsy.
Abstract:
Aim: To report on the safety of using Onabotulinumtoxin A (OnaA) in the upper limb(s) of children <2 years of age with cerebral palsy and to describe a proactive clinical model of care in the management of upper limb impairment in children with cerebral palsy. Methods and procedures: Retrospective chart audit of 65 infants aged 13-23 months (mean 18.69) who received upper limb OnaA injections. Administration procedures, trends in muscle selection, and adverse events were examined. Results: Adverse events were reported in 6 (4%) of the 65 children. Across the study period, muscles that control thumb and forearm movements were most commonly injected. The number of OnaA injections to subscapularis and flexor digitorum profundus increased over this period. Conclusions and implications: OnaA is a safe treatment option for the short-term management of focal upper limb muscle overactivity in children under 2 years of age with cerebral palsy. In line with existing evidence, OnaA should always be considered as an adjunct to evidence-based therapy.
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