Ultrasound-guided botulinum toxin injections for upper limb spasticity in cerebral palsy: A clinical study

Objective To evaluate the clinical effect of ultrasound-guided botulinum toxin A (BTX-A)injection for upper limb spasticity in children with cerebral palsy.Methods Twenty children with upper limb spasticity resulting from cerebral palsy were divided equally into a BTX-A injection group and a control group. Both groups received standard rehabilitation treatment. For the injection group, color ultrasonography was used to guide the accurate injection of BTX-A into the spastic muscles of the arm. They received rehabilitation training the day after the injection. For all patients, muscle spasticity and upper limb movement and function were evaluated before treatment and 1, 2, 4, 8 and 12 weeks later using a modified Ashworth scale and the Fugl-Meyer assessment.Results After two weeks of treatment, muscle spasticity and upper limb movement and function in the injection group were significantly better than before the injection.The improvement in muscle spasticity was greatest two weeks after the injection. The average therapeutic effect in the injection group was significantly better than among the controls.Conclusion BTX-A injection under ultrasound guidance helps relieve upper limb spasticity in cerebral palsy. It has the advantages of accurate localization and safety and gives superior results compared to rehabilitation treatment alone. Key words: Botulinum toxin;  Ultrasound;  Cerebral palsy;  Upper limb;  Spasticity