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  • Chapter 17 - The Use of Botulinum Neurotoxin in Spastic Infantile Cerebral Palsy

  • Edited by Daniel Truong, University of California, Riverside, Dirk Dressler, Hannover Medical School, Mark Hallett, National Institutes of Health (NIH), Christopher Zachary, University of California, Irvine, Mayank Pathak, Truong Neuroscience Institute
  • Book:
    Manual of Botulinum Toxin Therapy
    Published online:
    02 November 2023
    Print publication:
    23 November 2023, pp 125-132

  • Summary

    Cerebral palsy is not a specific disease, but a clinical syndrome caused by a non-progressive injury to the developing brain that results in a disorder of movement and posture that is permanent but not unchanging. Spasticity is the most common movement disorder, affecting between 60% and 80% of children with cerebral palsy, and can manifest as spastic hemiplegia, spastic diplegia and spastic quadriplegia. Dystonia is characterized by involuntary sustained or intermittent muscle contractions that cause twisting and repetitive movements, abnormal postures or both. Athetosis, or intermittent writhing movement, is also very common. These movement disorders are all amenable to treatment with botulinum neurotoxin (BoNT). This chapter discusses topographical symptom distribution and illustrates the typical forms of cerebral palsy using an anatomical approach to management. Common clinical patterns of spastic posturing, the major involved, muscles and dose ranges for the different toxin preparations are tabulated.