Recommendations for the use of botulinum toxin type A in the management of cerebral palsy

H. Kerr Graham, K. Roger Aoki, Ilona Autti-Rämö, Roslyn N. Boyd, Mauricio R. Delgado, Deborah J. Gaebler-Spira, Mark E. Gormley, Barry M. Guyer, Florian Heinen, Andrew F. Holton, Dennis Matthews, Guy Molenaers, Francesco Motta, Pedro J. García Ruiz, Jörg Wissel

Research output: Contribution to journalReview articlepeer-review

329 Scopus citations


Botulinum toxin type A (BTX-A) is increasingly being used for the treatment of childhood spasticity, particularly cerebral palsy. However, until very recently, all such use in this indication has been unapproved with no generally accepted treatment protocols, resulting in considerable uncertainty and variation in its use as a therapeutic agent. In view of the increasing awareness of, and interest in, this approach to the treatment of spasticity, and also the recent licensing in a number of countries of a BTX-A preparation for treating equinus deformity in children, it would seem timely to establish a framework of guidelines for the safe and efficacious use of BTX-A for treating spasticity in children. This paper represents an attempt, by a group of 15 experienced clinicians and scientists from a variety of disciplines, to arrive at a consensus and produce detailed recommendations as to appropriate patient selection and assessment, dosage, injection technique and outcome measurement. The importance of adjunctive physiotherapy, orthoses and casting is also stressed. Copyright (C) 2000 Elsevier Science B.V.

Original languageEnglish (US)
Pages (from-to)67-79
Number of pages13
JournalGait and Posture
Issue number1
StatePublished - Feb 2000


  • BOTOX®
  • Botulinum toxin type A
  • Cerebral palsy
  • Consensus document
  • Guidelines

ASJC Scopus subject areas

  • Biophysics
  • Orthopedics and Sports Medicine
  • Rehabilitation


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