ReviewToxins2020
Over 25 Years of Pediatric Botulinum Toxin Treatments: What Have We Learned from Injection Techniques, Doses, Dilutions, and Recovery of Repeated Injections?
Review in Toxins, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis 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
21 citing papers in PubMed, 1 synthesis or guideline pooled it, 71 citations in OpenAlex.
- Limited Evidence of Functional Benefit After Upper Limb Botulinum Toxin Treatment in Children With Cerebral Palsy: Systematic Review and Meta-analysis.American journal of physical medicine & rehabilitation · 2025Pooled it
- Does botulinum neurotoxin A make walking easier in children with cerebral palsy? A randomized clinical trial.Developmental medicine and child neurology · 2025Trial
- IncobotulinumtoxinA for the treatment of lower-limb spasticity in children and adolescents with cerebral palsy: A phase 3 study.Journal of pediatric rehabilitation medicineTrial
- Italian Expert Consensus on the Efficacy and Safety of High Doses of Incobotulinum Toxin A (BocoutureDermatology and therapy · 2026Review
- Why Dosing Matters: A Closer Look at the Dose-Response Relationship With OnabotulinumtoxinA.Journal of cosmetic dermatology · 2025Review
- Intra-pyloric botulinum toxin injection improves liquid gastric emptying usingAsia Oceania journal of nuclear medicine & biology · 2025Article
- Correspondence between Expected, Perceived, and Measured Effects of BoNT-A Treatment in Calf Muscles among Children and Adolescents with Cerebral Palsy: A Mixed Methods Study.Journal of clinical medicine · 2024Article
- Influence of vitamin D on muscle strength and botulinum toxin dosage through surface electromyography.Acta cirurgica brasileira · 2024Article
- The Non-Affected Muscle Volume Compensates for the Partial Loss of Strength after Injection of Botulinum Toxin A.Toxins · 2023Article
- The Relationship between Pain and Spasticity and Tell-Tale Signs of Pain in Children with Cerebral Palsy.Toxins · 2023Article
- Giant omphalocele: A novel approach for primary repair in the neonatal period using botulinum toxin.Revista do Colegio Brasileiro de Cirurgioes · 2023Article
- How mechanics of individual muscle-tendon units define knee and ankle joint function in health and cerebral palsy-a narrative review.Frontiers in bioengineering and biotechnology · 2023Review
- Review
- Article
- Measuring Effects on Pain and Quality of Life after Abobotulinum Toxin A Injections in Children with Cerebral Palsy.Toxins · 2022Article
- The Effect of Botulinum Toxin-A on Chronic Muscle-Related Pain in Cerebral Palsy.Frontiers in neurology · 2022Article
- Observational
- Botulinum toxin injection for Cockayne syndrome with muscle spasticity over bilateral lower limbs: A case report.World journal of clinical cases · 2021Article
- Drug Development Using Natural Toxins.Toxins · 2021Article
- Botulinum Toxin: From Poison to Possible Treatment for Spasticity in Spinal Cord Injury.International journal of molecular sciences · 2021Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
1 author at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Botulinum toxin type A (BTXA) has been used for over 25 years in the management of pediatric lower and upper limb hypertonia, with the first reports in 1993. The most common indication is the injection of the triceps surae muscle for the correction of spastic equinus gait in children with cerebral palsy. The upper limb injection goals include improvements in function, better positioning of the arm, and facilitating the ease of care. Neurotoxin type A is the most widely used serotype in the pediatric population. After being injected into muscle, the release of acetylcholine at cholinergic nerve endings is blocked, and a temporary denervation and atrophy ensues. Targeting the correct muscle close to the neuromuscular junctions is considered essential and localization techniques have developed over time. However, each technique has its own limitations. The role of BTXA is flexible, but limited by the temporary mode of action as a focal spasticity treatment and the restrictions on the total dose deliverable per visit. As a mode of treatment, repeated BTXA injections are needed. This literature reviewed BTXA injection techniques, doses and dilutions, the recovery of muscles and the impact of repeated injections, with a focus on the pediatric population. Suggestions for future studies are also discussed.
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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.