PMID- 36723611
OWN - NLM
STAT- MEDLINE
DCOM- 20230802
LR  - 20230802
IS  - 1473-5865 (Electronic)
IS  - 1060-152X (Linking)
VI  - 32
IP  - 5
DP  - 2023 Sep 1
TI  - Adverse effects following botulinum toxin A injections in children with cerebral 
      palsy.
PG  - 435-451
LID - 10.1097/BPB.0000000000001055 [doi]
AB  - The study aimed to analyze the adverse events associated with botulinum toxin A 
      (BoNT-A) injections in children with cerebral palsy (CP). The literature search 
      was completed using the Medline, PubMed, Google Scholar, Scopus, and Cochrane 
      Library databases from the earliest date possible up to December 2021. Search 
      terms included 'botulinum toxin', 'cerebral palsy', 'spasticity', 'adverse 
      effects', 'side effects', 'undesirable effects', 'complications', 'lower limb', 
      'upper limb', and 'children' including combinations of index and free-text terms. 
      Fifty-five studies were included in the study. Data on 6333 pediatric patients 
      and more than 14 080 BoNT-A injections were collected. Respiratory symptoms and 
      respiratory tract infections were the most frequently registered adverse events 
      (AEs). Other common AEs included procedural/focal AEs, flu-like symptoms, and 
      asthenia. Sentinel events including four cases of death were reported. AEs were 
      more frequent and severe in high-dose patients; however, the capacity of BoNT-A 
      to spread systemically remains unclear. Since severe adverse events are not 
      common, further research is needed to collect more definitive clinical and 
      homogeneous data to support the findings of the present research and clarify the 
      safety profile of BoNT-A, especially regarding the incidence of respiratory 
      issues and complications in GMFCS IV or V patients.
CI  - Copyright (c) 2023 Wolters Kluwer Health, Inc. All rights reserved.
FAU - Sapienza, Marco
AU  - Sapienza M
AD  - Department of General Surgery and Medical Surgical Specialties, Section of 
      Orthopaedics and Traumatology, P.O. 'Policlinico Gaspare Rodolico', University of 
      Catania, Catania, Italy.
AD  - Department of Pediatric Orthopedic Surgery, Jeanne de Flandre Hospital, Lille 
      University Centre, Lille, France.
FAU - Kapoor, Rahul
AU  - Kapoor R
AD  - Children's Orthopaedic Centre, Mumbai, India.
FAU - Alberghina, Flavia
AU  - Alberghina F
AD  - Pediatric Orthopaedic Department, Children's Health Ireland, Dublin.
FAU - Maheshwari, Ratna
AU  - Maheshwari R
AD  - Children's Orthopaedic Centre, Mumbai, India.
FAU - McCracken, Kathryn Louise
AU  - McCracken KL
AD  - University College Cork School of Medicine, Cork, Ireland.
FAU - Canavese, Federico
AU  - Canavese F
AD  - Department of Pediatric Orthopedic Surgery, Jeanne de Flandre Hospital, Lille 
      University Centre, Lille, France.
FAU - Johari, Ashok N
AU  - Johari AN
AD  - Children's Orthopaedic Centre, Mumbai, India.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20230119
PL  - United States
TA  - J Pediatr Orthop B
JT  - Journal of pediatric orthopedics. Part B
JID - 9300904
RN  - EC 3.4.24.69 (Botulinum Toxins, Type A)
RN  - 0 (Neuromuscular Agents)
SB  - IM
MH  - Child
MH  - Humans
MH  - *Botulinum Toxins, Type A/adverse effects
MH  - *Cerebral Palsy/drug therapy/complications
MH  - Injections, Intramuscular/adverse effects
MH  - Muscle Spasticity/complications
MH  - *Neuromuscular Agents/adverse effects
MH  - Paralysis/chemically induced/complications
MH  - Upper Extremity
EDAT- 2023/02/02 06:00
MHDA- 2023/08/01 06:44
CRDT- 2023/02/01 11:03
PHST- 2023/08/01 06:44 [medline]
PHST- 2023/02/02 06:00 [pubmed]
PHST- 2023/02/01 11:03 [entrez]
AID - 01202412-990000000-00085 [pii]
AID - 10.1097/BPB.0000000000001055 [doi]
PST - ppublish
SO  - J Pediatr Orthop B. 2023 Sep 1;32(5):435-451. doi: 10.1097/BPB.0000000000001055. 
      Epub 2023 Jan 19.