Effect of Botulinum Toxin Injection in Treatment of Upper Limb Spasticity in Childhood Cerebral Palsy: A Systematic Review

Abstract Cerebral palsy (CP) is the most common cause of childhood disability globally. It manifests in restricted functional mobility and impacts the quality of life negatively. Botulinum toxin injections are widely used to manage limb spasticity in children with cerebral palsy. In the upper limbs of CP children intramuscular botulinum toxin-A has been used to manage pre and post-operative pain, facilitate nursing and achieve functional and/or cosmetic improvement of hand position. These goals are achieved primarily through reduction of spasticity.. This review aims at providing the evidence for effect of botulinum toxin-A injections to manage upper limb spasticity in spastic cerebral palsy cases. The literature extraction process yielded 15 articles for inclusion in this review. After reviewing these articles we concluded that botulinum toxin-A had a positive effect on the degree of spasticity, motor functions and cosmetic appearance of the injected upper limb but its effect increased by addition of another regimen as O.T.,P.T, casting or splintage.