Systematic evaluation of the efficacy and safety of botulinum toxin type A in the treatment of spastic cerebral palsy

Abstract

Background: Botulinum toxin type A (BTX-A) is a neuromuscular blocking agent. BTX-A inhibits acetylcholine release, causes neuromuscular transmission impairment, and decreases muscle spasms. Objective: To explore the efficacy and safety of BTX-A injection in the treatment of spastic cerebral palsy through systematic evaluation and to provide a reference for the clinical use of BTX-A. Methods: We used “Cerebral palsy” and “BTX-A” as the subject terms and used a combination of subject terms and free words for the search. We searched 7 databases, including CNKI, Wanfang, VIP, Sinomed, PubMed, Embase, and Web of science. Based on the inclusion and exclusion criteria, we screened the articles by reading their titles, abstracts, and full texts and finally included relevant literature for systematic evaluation. Result: A total of 93 papers were systematically evaluated, revealing that BTX-A injection treatment can effectively reduce muscle tone, increase joint mobility, improve gait and motor posture, and enhance gross motor movements in patients with spastic cerebral palsy. The benefits of BTX-A treatment can be sustained for 3–6 months, with motor ability improvement lasting up to 1 year. Combining BTX-A treatment with rehabilitation or external fixation therapy can enhance its efficacy. However, the effectiveness of BTX-A treatment is influenced by several factors, such as the dosage, number of injections, and patient age. Adverse reactions to BTX-A treatment are typically mild and can be relieved within 1–2 weeks. Conclusion: BTX-A injection is relatively safe but reversible.