Botulinum toxin type A neuromuscular blockade in the treatment of lower extremity spasticity in cerebral palsy: a randomized, double-blind, placebo-controlled trial. BOTOX Study Group

J Pediatr Orthop. 2000 Jan-Feb;20(1):108-15.


Increased gastrocnemius/soleus muscle tone in children with cerebral palsy may cause an equinus of the ankle. Botulinum toxin type A (BTX), a neuromuscular blocking agent, reduces muscle tone in various neuromuscular disorders. The safety and short-term efficacy of BTX injections were evaluated in a prospective, 3-month, double-blind, randomized clinical trial involving 114 children with cerebral palsy and dynamic equinus foot deformity. Outcome was determined by observational gait analysis, ankle range-of-motion measurements, and quantification of muscle denervation by nerve conduction. Patients in the BTX group demonstrated improved gait function and partial denervation of the injected muscle. No serious adverse events were reported.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Botulinum Toxins, Type A / therapeutic use*
  • Cerebral Palsy / complications*
  • Child
  • Child, Preschool
  • Double-Blind Method
  • Equinus Deformity / drug therapy
  • Equinus Deformity / etiology
  • Equinus Deformity / physiopathology
  • Gait
  • Humans
  • Leg*
  • Muscle Spasticity / drug therapy*
  • Muscle Spasticity / etiology*
  • Muscle Spasticity / physiopathology
  • Neuromuscular Agents / therapeutic use*
  • Neuromuscular Blockade*
  • Prospective Studies
  • Range of Motion, Articular


  • Neuromuscular Agents
  • Botulinum Toxins, Type A