Spastic Cerebral Palsy
Spastic CP means the muscles are tense and tight. This occurs because the brain is not sending the right signals to the muscles. Muscle stiffness affects all aspects of the child’s activities of daily living.
The long-term effects of muscle stiffness are:
- Pain due to changes in joint position caused by abnormal pull of the spastic muscle
- Bone deformities caused by the shortened muscles pulling on the bony structures
- Shortened muscles due to lack stretching
- Atrophy of muscles caused by changes in soft tissues (muscles, tendons, and ligaments)
Treatment for spastic cerebral palsy includes physical therapy, surgery and botox injections to the muscles. Although physical therapy had been the treatment of choice, doctors are now recommending botox injections as part of treatment.
What is Botox?
Botox is a substance made by bacteria. The toxin can be purified and used safely and effectively.
It is used to treat over 20 different medical conditions. Although Botox is an off-label use for cerebral palsy treatment, it has proven to be effective.
This drug helps to reduce muscle tightness without surgical intervention. Treatments can only be administered by a trained physician.
How is Botox Administered?
The physician may administer an injectable medication to help with discomfort. The injection is given into a shortened muscle.
Typically, Botox injections are used in combination with a cast and physical therapy. The cast is used to improve the position of the extremities. It is recommended to use the cast one or two weeks after the botox administration.
What Happens After the Botox Injection?
After the injection, you will notice results as early as 3-5 days. The muscle is weakened, which in turn, allows muscles to be stretched. Although the result is significant it only lasts a few months and will require several treatments. The frequency of treatments will be determined by your child’s treating physician.
Some benefits of using Botox injections:
- Improves range of motion
- Decreased muscle tightness
- Improved gait
- Muscle stretches easier
Although there are several benefits of using Botox to treat spastic cerebral palsy it is important to know the side effects of botox.Most of the side effects are temporary, however, if any questions arise please make sure to contact your physician’s office.
Some things to watch for at the site of your child's botox injection:
- Extremity weakness
What Happens Before the Next Treatment?
Before each treatment, your physician will perform a thorough evaluation. It is important that the medical team documents the benefits of the previous treatment. The physician will determine if your child is able to receive a dose of botox.
A few reasons that your child’s physician may not administer a dose of Botox:
- Cold or flu symptoms
- Immunizations received within the last week or scheduled to receive them within the week
The Johnsons Share Their Story
The Johnsons from Sacramento, have twins Athena and E.J. They were both diagnosed with cerebral palsy at 9 months old.
Unlike, her brother, E.J., Athena, was faced with more physical challenges. The neurologist told the Johnsons that she may not be able to walk. Hearing the neurologist say that was frightening. At the age of 5, doctors recommended botox to treat her spastic legs.
“It was a little bit weird to think of treatment that is more of a cosmetic type of a thing,” said Athena’s father, George Johnson.
Thanks to botox as well as the experience of the Shriners medical team, Athena is a very active 12-year-old.
To learn more about Athena’s inspiring story, check out this short video.