Severity of cerebral palsy and likelihood of adverse events after botulinum toxin A injections

Abstract

Adverse events reported at the time of botulinum toxin A injection occurred in 6% of injection episodes. Adverse events were reported at follow-up in 22% of injection episodes. Children in Gross Motor Function Classification System (GMFCS) levels IV and V have increased rates of systemic adverse events. Children in GMFCS levels IV and V report less local weakness and pain.

Systemic adverse events after botulinum neurotoxin A injections in children with cerebral palsy

“…Improving understanding about the potential adverse events related to BoNT‐A treatment in children with CP is highly important to clinicians and families. In this study we aimed to build on the findings of our previous study . We examined factors that increase the likelihood of the most concerning adverse events, those that suggest systemic spread of the toxin to distant parts of the body, with the intention of improving understanding of which children with CP have the greatest likelihood of experiencing systemic adverse events.…”

“…In this study we aimed to build on the findings of our previous study. 20 We examined factors that increase the likelihood of the most concerning adverse events, those that suggest systemic spread of the toxin to distant parts of the body, with the intention of improving understanding of which children with CP have the greatest likelihood of experiencing systemic adverse events. We found evidence of systemic adverse events in 3.6% of BoNT-A injection episodes.…”

“…The setting has been described previously . Children who attend the clinic typically undergo assessment for injection of BoNT‐A in the same half‐day time period.…”

“…The setting has been described previously. 11,20 Children who attend the clinic typically undergo assessment for injection of BoNT-A in the same half-day time period. Assessment is undertaken by a multidisciplinary team consisting of a rehabilitation paediatrician, physiotherapist, and occupational therapist; goals for BoNT-A and target muscles are agreed at this stage.…”

Botulinum toxin: did the black box warning change how we treat children with cerebral palsy?

“…Fortunately, we have now accumulated additional information about BoNT adverse event risk in children with CP . Recent studies continue to report that most BoNT adverse events are mild and self‐limiting, with relatively low rates of serious adverse events . However, adverse event rates are generally higher than those previously reported due to better methods of assessment.…”