BOTULINUM TOXIN-A IN THE MANAGEMENT OF CHILDREN WITH CEREBRAL-PALSY -INDICATIONS AND OUTCOME

There is now considerable evidence to support the use of botulinum tox in A in the treatment of children with cerebral palsy. However, the cl inical variability of cerebral palsy demands careful assessment and pl anning of treatment to obtain optimal results. Our approach to clinica l assessment and management includes the use of three-dimensional gait analysis to answer specific clinical issues and evaluate the function al outcome. Botulinum toxin A should be used as part of an integrated programme in the management of children with cerebral palsy which also includes physiotherapy, orthoses and orthopaedic surgery. A managemen t algorithm for the use of this toxin as therapy in children with cere bral palsy has been developed, based on our clinical experience and th e results of a number of clinical trials.