Systemic adverse events after botulinum neurotoxin A injections in children with cerebral palsy

Developmental Medicine and Child Neurology
Simon P PagetS O'Flaherty

Abstract

To identify factors that increase the likelihood of systemic adverse events after botulinum neurotoxin A (BoNT-A) injections in children with cerebral palsy (CP). A prospective observational study of patients attending a BoNT-A clinic at a tertiary paediatric hospital (2010-2014). Occurrences of systemic adverse events, defined as lower respiratory tract illnesses, generalized weakness, dysphagia, and death were determined at follow-up. The relationship between systemic adverse events and eight preinjection variables (age, Gross Motor Function Classification System [GMFCS] level, history of dysphagia, gastrostomy, aspiration pneumonia, recent history of illness, BoNT-A dose, and type of sedation) were examined using univariable and multivariable logistic regression with generalized estimating equations methods. In total 591 children underwent 2219 injection episodes with follow-up in 2158 (97%) cases. Systemic adverse events were reported in 77 (3.6%) injection episodes. Univariable analysis suggested that GMFCS levels IV and V, a history of dysphagia, gastrostomy, aspiration pneumonia, and increasing BoNT-A dose increase the likelihood of systemic adverse events. In multivariable analysis, a history of dysphagia (odds ratio [O...Continue Reading

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Citations

Sep 2, 2018·Developmental Medicine and Child Neurology·Antigone S Papavasiliou
Mar 29, 2019·Movement Disorders : Official Journal of the Movement Disorder Society·Shekeeb S MohammadRussell C Dale
Mar 16, 2019·Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova·O A Klochkova, A L Kurenkov
Jun 23, 2020·Journal of Pediatric Rehabilitation Medicine·Joshua A Vova, Enoch Leung
Jan 19, 2021·Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova·A L KurenkovKh M Karimova
May 27, 2021·Journal of Paediatrics and Child Health·Stephen J O'Flaherty, Kirsty Stewart
Jun 1, 2021·Journal of Pediatric Rehabilitation Medicine·Edward Wright, Lauren Fetsko
Sep 25, 2021·PM & R : the Journal of Injury, Function, and Rehabilitation·Joshua A VovaMatthew J McLaughlin

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