Botulinum Toxin as Treatment Modality for Spastic Diplegic Cerebral Palsy Child: Our experience in 21 patients

Spasticity in cerebral palsy is one of its most important and common clinical presentation. It produces contractures, deformities and also hampers physiotherapy if not treated. For treatment of spasticity there are various modalities like stretching exercises, casts, muscle relaxants, phenol injections, intraspinal baclofen pump and dorsal selective rhizotomy. Botulinum toxin A, neuromuscular blocker, is a newer addition in this list. We have done a prospective uncontrolled study in 21 patients with diplegic spastic cerebral palsy. The toxin was injected in lower limbs for spastic hamstrings and gastrosoleus. The average age of patients was 6.1yrs. Average number of injection given was one. The patients were followed up for 6 months after injection. We conclude that Botulinum toxin A is a good muscle relaxant, easy to administer and has negligible side effects. It improves tolerance to cast application and physiotherapy which makes the rehabilitation of patient easy. Except the cost of therapy and its “window period” it is best modality of treatment for the spastic diplegic cerebral palsy patients.