Semin Neurol 2016; 36(01): 064-072
DOI: 10.1055/s-0036-1571847
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Botulinum Toxin Treatment of Spasticity in Adults and Children

Iman Moeini-Naghani
1   Department of Neurology, Yale University School of Medicine, New Haven, Connecticut
,
Taraneh Hashemi-Zonouz
2   Department of Diagnostic radiology, Yale University School of Medicine, New Haven, Connecticut
,
Bahman Jabbari
1   Department of Neurology, Yale University School of Medicine, New Haven, Connecticut
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Publikationsdatum:
11. Februar 2016 (online)

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Abstract

Spasticity is a frequent symptom in stroke, multiple sclerosis, cerebral or spinal trauma, and cerebral palsy that affects and disables a large number of adults and children. In this review, we discuss the pathophysiology and nonpharmacologic and pharmacologic treatments of spasticity with emphasis on the role of botulinum neurotoxins (BoNTs). The world literature is reviewed on double-blind and placebo-controlled clinical trials reporting safety and efficacy of BoNT treatment in adult spasticity and spasticity of children with cerebral palsy. The evidence for efficacy is presented from recommendations of the Assessment and Therapeutics subcommittee of the American Academy of Neurology. A technical section describes the techniques and recommended doses of BoNTs in spasticity.