ReviewToxins2015
Best clinical practice in botulinum toxin treatment for children with cerebral palsy.
Review in Toxins, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 45 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
45 citing papers in PubMed, 2 syntheses or guidelines pooled it, 141 citations in OpenAlex.
- Botulinum Toxin A Injection in Treatment of Upper Limb Spasticity in Children with Cerebral Palsy: A Systematic Review of Randomized Controlled Trials.JBJS reviews · 2020Pooled it
- Efficacy of botulinum toxin type A for spasticity management and motor function in children with cerebral palsy: a systematic review and meta-analysis of randomized controlled trials.Frontiers in neurologyPooled it
- Effectiveness and safety of abobotulinumtoxinA in pediatric lower limb spasticity: A phase IV, prospective, observational, multicenter study.Developmental medicine and child neurology · 2026Trial
- Goal Attainment after Treatment with Abobotulinumtoxina and a Tailored Home Therapy Programme in Children with Upper Limb Spasticity: Descriptive, Exploratory Analysis of a Large Randomized, Controlled StudyJournal of rehabilitation medicine · 2022Trial
- Efficacy and safety of onabotulinumtoxinA with standardized physiotherapy for the treatment of pediatric lower limb spasticity: A randomized, placebo-controlled, phase III clinical trial.NeuroRehabilitation · 2022Trial
- Efficacy and safety of abobotulinumtoxinA for upper limb spasticity in children with cerebral palsy: a randomized repeat-treatment study.Developmental medicine and child neurology · 2021Trial
- Botulinum Toxin Type A Injections Impact Hamstring Muscles and Gait Parameters in Children with Flexed Knee Gait.Toxins · 2020Trial
- A novel sensor-based assessment of lower limb spasticity in children with cerebral palsy.Journal of neuroengineering and rehabilitation · 2018Trial
- Trial
- AbobotulinumtoxinA (DysportJournal of child neurology · 2017Trial
- Trial
- Trial
- Botulinum Toxin in Children and Adolescents-A Comprehensive Review of Clinical Applications.Toxins · 2026Review
- Determinant Factors for The Efficacy of Botulinum Toxin Injections on Lower Limb Function in Cerebral Palsy: Two Year Follow-up Study.Sisli Etfal Hastanesi tip bulteni · 2026Article
- Botulinum-Toxin-Induced Muscle Fasciculations in Children with Cerebral Palsy: A Case-Series Study.Brain sciences · 2025Article
- Botulinum Neurotoxin A-Induced Muscle Morphology Changes in Children with Cerebral Palsy: A One-Year Follow-Up Study.Toxins · 2025Article
- Article
- Switox: Retrospective Analysis of Botulinum Toxin Switching in Management of Spasticity.Toxins · 2025Article
- Enhancements in Parkinson's Disease Management: Leveraging Levodopa Optimization and Surgical Breakthroughs.Current drug targets · 2025Review
- Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 6 institutions in 6 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Botulinum toxin A (BoNT-A) is considered a safe and effective therapy for children with cerebral palsy (CP), especially in the hands of experienced injectors and for the majority of children. Recently, some risks have been noted for children with Gross Motor Classification Scale (GMFCS) of IV and the risks are substantial for level V. Recommendations for treatment with BoNT-A have been published since 1993, with continuous optimisation and development of new treatment concepts. This leads to modifications in the clinical decision making process, indications, injection techniques, assessments, and evaluations. This article summarises the state of the art of BoNT-A treatment in children with CP, based mainly on the literature and expert opinions by an international paediatric orthopaedic user group. BoNT-A is an important part of multimodal management, to support motor development and improve function when the targeted management of spasticity in specific muscle groups is clinically indicated. Individualised assessment and treatment are essential, and should be part of an integrated approach chosen to support the achievement of motor milestones. To this end, goals should be set for both the long term and for each injection cycle. The correct choice of target muscles is also important; not all spastic muscles need to be injected. A more focused approach needs to be established to improve function and motor development, and to prevent adverse compensations and contractures. Furthermore, the timeline of BoNT-A treatment extends from infancy to adulthood, and treatment should take into account the change in indications with age.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.