It is a toxin produced by bacteria called clostridia. It is purified to medical grade and is used for spasticity management since 1993.

This drug has to be injected in the affected muscle. This drug can be injected with topical analgesia but when child is small and multiple muscles are selected for injections then general anaesthesia or conscious sedation is preferred. The onset of the action starts in 12 to 72 hours and lasts for 3-6 months but beneficial clinical effects may last much longer if child has good physiotherapy back up.During this period with physiotherapy and use of splints child can be guided to achieve milestones.

For instance this four year old boy who was not able to stand due to spasticity in his calf muscle and hamstrings (muscles at the back of the knee), was given botulinum injections in both muscles in both legs.

He started stadnign with help of splints and could walk after regular physiotherapy after four months of injection. Though the effect of botulinum toxin lasts for few months the beneficial effects can last for years provided the child is regular in physiotherapy and is wearing prescribed splints regularly.

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Children’s Orthopaedic Centre is one of the few centres where Botulinum injections are given with special technique of electrical stimulations which allows increases the accuracy of the drug significantly.

Upper limb CP botulinum toxin injections

Use of botulinum toxin (Botox) is also found to be useful in upper limbs. It requires smaller dosages and prevents contracture developments and allows clenched fist to open and bimanual function to develop.