Assessment: Botulinum neurotoxin for the treatment of spasticity (an evidence-based review): report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology

Neurology. 2008 May 6;70(19):1691-8. doi: 10.1212/01.wnl.0000311391.00944.c4.


Objective: To perform an evidence-based review of the safety and efficacy of botulinum neurotoxin (BoNT) in the treatment of adult and childhood spasticity.

Methods: A literature search was performed including MEDLINE and Current Contents for therapeutic articles relevant to BoNT and spasticity. Authors reviewed, abstracted, and classified articles based on American Academy of Neurology criteria (Class I-IV).

Results: The highest quality literature available for the respective indications was as follows: adult spasticity (14 Class I studies); spastic equinus and adductor spasticity in pediatric cerebral palsy (six Class I studies).

Recommendations: Botulinum neurotoxin should be offered as a treatment option for the treatment of spasticity in adults and children (Level A).

Publication types

  • Meta-Analysis

MeSH terms

  • Adult
  • Age Factors
  • Botulinum Toxins / administration & dosage*
  • Child
  • Clinical Trials as Topic / statistics & numerical data
  • Dose-Response Relationship, Drug
  • Evidence-Based Medicine / methods
  • Humans
  • Muscle Spasticity / drug therapy*
  • Muscle Spasticity / etiology
  • Muscle Spasticity / physiopathology
  • Muscle, Skeletal / drug effects*
  • Muscle, Skeletal / innervation
  • Muscle, Skeletal / physiopathology
  • Neuromuscular Blocking Agents / administration & dosage*
  • Treatment Outcome


  • Neuromuscular Blocking Agents
  • Botulinum Toxins