Botulinum Toxin Injections for Pediatric Patients With Hereditary Spastic Paraparesis

Limited information is available on the use of botulinum toxin type A injections for children with hereditary spastic paraplegia. This report includes 12 children with hereditary spastic paraplegia (mean age 4.8 ± 2.5 years) who underwent 1 to 6 sessions of botulinum toxin A injections to the hamstrings, adductors and gastrocnemius muscles. Patients showed both improved muscle tone (mean 1.9 ± 0.5 vs 1.18 ± 0.33, P < .001, Ashworth Scale) and motor function (75.3 ± 11.9 vs 77.7 ± 11, P < .001, Gross Motor Function Measure). The effect lasted for a mean of 6.6 ± 3.6 months. During the study period (mean 2.8 ± 1.8 years), the preinjection Gross Motor Function Measure increased (69.2 ± 14.7 vs 78.3 ± 13.5, P = .005), whereas the Ashworth Scale remained stable, suggesting a prolonged effect of botulinum toxin A on motor function. The authors conclude that botulinum toxin A injections to lower limbs of pediatric patients with hereditary spastic paraplegia result in prolonged functional improvement despite the progressive nature of the disease.