This paper reports the results of botulinum toxin A treatment in 13 ch
ildren with cerebral palsy. All patients except one exhibited dynamic
deformities in one hand or foot and changes in muscle tone of corticos
pinal and extrapyramidal origin. The primary purpose of the treatment
was to improve the impaired skilled movements which resulted from dyst
onic limb posture and were the most disabling symptoms in the group st
udied. The study showed that the botulinum toxin treatment produced a
significant improvement in functional disability in terms of ameliorat
ion of skilled hand movements and foot posture (p < 0.01). The injecti
ons took effect a few days after dystonic muscle infiltration, and the
mean duration of improvement was 3.1 months (2.0 - 4.0 months). Side
effects were negligible and transient; transitory muscle weakness was
the most frequent. Botulinum toxin A provides a safe and effective adj
uvant treatment of dystonic skilled movements and gait disorders in ch
ildren with cerebral palsy