Botulinum Neurotoxin for Spasticity

An evidence-based literature review finds that botulinum neurotoxin should be offered as an option for the treatment of spasticity in adults and children.

This evidence-based review is a report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology (AAN). Using the AAN criteria for the classification of evidence, the authors reviewed the literature on “the safety and efficacy of botulinum neurotoxin (BoNT) in the treatment of adult and childhood spasticity.”

For the treatment of spasticity in adults, they found 14 Class I trials (11 for upper- and 3 for lower-extremity spasticity), most of which showed that BoNT reduced muscle tone. Some studies suggested functional improvement, mostly in passive function.

The section on childhood spasticity focuses exclusively on children with cerebral palsy (CP). For the treatment of equinovarus, the authors reported f…

Reviewing Author

Mel Glenn, MD