Ultrasound guided injection of Botox is part of the multidisciplinary treatment of spasticity offered in ALYN. Plaster casting or bracing of the injected limb and physiotherapy complete the treatment.
Spasticity is a condition seen in many children with Cerebral Palsy in which there is an abnormal increase in muscle tone or stiffness in the muscles; this can interfere with movement or development of motor skills such as grasping objects, sitting, crawling, walking, etc.
Spasticity can be reduced by using Botulinum Toxin to delay muscle activation. Reduction in muscle tone allows physical treatment (physiotherapy, occupational therapy) to improve daily function and quality of life.
Before injecting the Botulinum Toxin, the skin is prepared with a local anesthetic (EMLA cream). Ultrasound or EMG (nerve conduction testing) may be used to increase the accuracy of the injection.
Botulinum Toxin’s effect
Most children show no complications and can resume regular activity almost immediately. In rare cases, the child may have a local reaction or general weakness.
Botulinum Toxin’s effect begins two to three days after the injection and reaches maximal effect two weeks later. The effect usually lasts three to four months. During this time the child’s treatments should be increased in order to take advantage of the opportunity for increased range of motion and functional improvement. Appliances (splints, immobilizers etc.) help maintain gains and should be used routinely.
The need for reinjection is evaluated a few months later. In some cases Botulinum Toxin injection can replace surgery, but in most cases it only allows surgery to be delayed for a few years. This delay enables the child to grow and develop prior to having surgery.