Injectable antispasmodic medications for cerebral palsy
Examples
Generic Name Brand Name alcohol "washes" botulinum toxin Botox phenol "washes" How It Works
Injectable medications, like other antispasmodic medications, relax muscles and reduce muscle spasticity. They act only on the nerves and muscles surrounding the area where they are injected. Health professionals give the injections directly into the affected muscle.
Why It Is Used
Injectable medications help relax tight muscles in the legs or arms affected by cerebral palsy. Injectable medications are used:
- When muscle tightness interferes with daily activities, especially walking.
- To increase the effectiveness of physiotherapy.
- To determine whether nerve surgery is appropriate. Doctors often can predict the potential success of surgery by how nerves and muscles react to the injected medication.
How Well It Works
These medications may improve the effectiveness of physiotherapy or delay the need for surgery on the muscles, tendons, and joints. If injectable medications successfully relax the nerves and muscles, surgical cutting of the nerves may also be helpful. However, the overall usefulness of these medications as treatment for cerebral palsy needs more research.1
Botulinum toxin (Botox) has been shown to improve the two main factors of leg spasticity: walking foot pattern and ankle position.2 However, further research is needed on its short-term and long-term effects on leg spasticity in children with cerebral palsy.1 Children between ages 2 and 6 years have shown the best response to botulinum toxin.3
An injectable treatment usually relaxes tight muscles for a limited time. Alcohol and phenol start to work right away and last about 3 to 6 months. Botox usually begins to take effect within 3 days after injection, although the full effects are frequently not evident for 1 to 2 weeks. The effects of Botox last for about 4 to 8 months.
Side Effects
The side effects of alcohol and phenol injections include:3
- Pain as the injection is given.
- Muscle stiffness (rarely can become permanent).
- Loss of feeling in area, sometimes lasting for several weeks.
Botox has a low rate of side effects. When side effects occur, they most often include:
- Pain at the site of the injection.
- Rash.
- Fatigue and weakness.
- Flu-like symptoms, such as nausea.
See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)
What To Think About
Botulinum toxin may be more useful than antispasmodic pills for treating cerebral palsy.
Drowsiness, often caused by medications taken by mouth to relax tight muscles and reduce muscle spasms, is not a problem with injectable medications.
Both alcohol and phenol can be injected directly into the nerve that supplies a muscle. This is called a nerve block or a motor point block.
Injectable botulinum toxin (Botox) can only be injected directly into a muscle.
- The advantages of using botulinum toxin are that it is easier to give and causes less muscle pain than the other injectable medications.
- The disadvantage of using botulinum toxin is that it costs more than alcohol and phenol. There also is less information on its safety when used over long periods of time.
Using injectable medications helps loosen tight muscles and joints and may prevent the need for braces, casts, or splints. If injectable medications relax nerves and muscles, surgery may be postponed or cancelled.
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| Author: | Douglas Dana Sabra L. Katz-Wise Ralph Poore | Last Updated: March 6, 2007 |
| Medical Review: | Anne C. Poinier, MD - Internal Medicine Michael J. Sexton, MD - Pediatrics Thomas Emmett Francoeur, MDCM, CSPQ, FRCPC - Pediatrics Louis Pellegrino, MD - Developmental Pediatrics | |
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| Topic Contents | |
| Examples | |
| How It Works | |
| Why It Is Used | |
| How Well It Works | |
| Side Effects | |
| What To Think About | |
| References | |