Pre- and Post-BTX:



Pre- and Post-BTX: This is a 12-year-old girl with spastic quadriplegic cerebral palsy secondary to prematurity. She has significant spasticity involving her lower extremities. The patient had multiple lower extremity orthopedic procedures approximately six months prior to botulinum toxin injections. They included detrotational osteotomies, gastrocnemius recession, hamstring lengthening and rectus femoris transfers.

Approximately six months after completion of the surgeries, her contractures recurred and a trial of intrathecal baclofen was recommended. The family refused ITB and further surgeries; therefore, botulinum toxin therapy was initiated. It should be noted here that if this patient were between 4-6 years of age, she might have been considered a good candidate for selective dorsal rhizotomy.
However, at this stage, and because of her family’s decision not to have further surgery, botulinum toxin injections were initiated. This patient had regular botulinum toxin injections with continual positive results. She does not wish to pursue further aggressive options at this time since she continues to respond well to the botulinum toxin.