Objective: Cerebral palsy is the most common cause of severe physical disability in childhood. Botulinum toxin type A (BTX-A), has rapidly gained acceptance as a different treatment for spasticity. However, no consensus exists among clinicians about optimal dose of BTX-A in pediatric patients. Doses of 2-6 U/ kg bodyweight with a maximum total dose of 29U/kg have been reported. This study was conducted due to uncertain dosage rage in pediatric use.
Method: In this study, 12 patients with cerebral palsy and spastic eqinus foot deformity who referred to our center, were treated with BTX-A in the dosage of 25 U/kg. After treatment of BTX-A, patients were followed up total of 6 months. Three months after treatment, Gross motor functional measurement (GMFM) and Modified Ashwort scale (MAS) were done. At the same time, questionnaires (PCQ) were filled for possible side effects.
Results: Average age of 6 girls and 6 boys were 4.5 ± 2.8 years. GMFM and MAS were done before and 3 months after treatment and were found statistically significant (p<0.05). Muscle soreness was the most common symptom at PCQ forms.
Conclusion: Using these two objective scales and PCQ form, high dose of BTX-A treatment was found statistically successful. Larger dose of BTX-A was used which was considered safe, effective and better tolerated by children. Titration of the dose of BTX-A, should be individualized for each patient due to different level of spasticity affecting patients in different ways.