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Use of Botox in Cerebral Palsy

Cerebral palsy is a non-progressive (does not become worse) neurological condition that develops in children and infants. It is marked by reduced ability to control bodily movements and muscles. The majority of cases are attributed to abnormalities in the prenatal development of or damage to portions of the brain responsible for controlling movement.

  1. Botox

    • Botox is a drug that is derived from a toxin made by Clostridium botulinum. It is typically injected in very small doses. It can weaken or create a paralytic effect in muscles. It is also capable of affecting nerves. It is used in cosmetic procedures to reduce the appearance of wrinkles. Other applications include treating cervical dystonia (severe contractions of neck and shoulder muscles) and blepharospasm (a condition in which there is excessive, uncontrolled blinking).

    Off-Label Use

    • The use of Botox to treat children with cerebral palsy is referred to as off-label use. The FDA issues guidelines regarding the appropriate uses of medications. Botox has been approved for cosmetic procedures to reduce the appearance of wrinkles and the treatment of a small number of other conditions. The treatment of cerebral palsy with Botox is not, as of 2009, approved by the FDA.

    Theory

    • The notion of using Botox as a treatment for cerebral palsy stems from the paralyzing effect that it has on muscles. One of the major obstacles that cerebral palsy sufferers frequently contend with is an intense muscle rigidity that often leaves them with an abnormal gait or muscles, which are effectively paralyzed by contraction. In theory, the weakening effect that Botox exerts on muscles could help to reduce that intense muscle rigidity that inhibits movement.

    Benefits

    • There are a variety of Botox benefits that have been reported. They include reduced spasticity (tight muscles), greater ease in stretching, improved range of motion and developmental improvements. There has been some research conducted in this area, including a 250-person study performed by the Walter Reed Medical Center. The results of the study, presented at the 2003 annual meeting of the American Academy of Neurology, reported that upwards of 86 percent of the children treated showed improvement following Botox injections.

    Controversy

    • While there does appear to be some valid evidence of the effectiveness of Botox as a treatment method for cerebral palsy, it is controversial and has attracted government and legal attention. The FDA issued a warning to medical professionals and consumers in 2008 after receiving a number of reports indicating severe side effects from cerebral palsy-related Botox injections, including some reported deaths. Additionally, the producers of Botox have been sued by at least one family claiming that Botox injections to treat their child's cerebral palsy led to the boy's death.

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