The updated European Consensus 2009 on the use of Botulinum toxin for children with cerebral palsy

Heinen, Florian; Desloovere, Kaat; Schroeder, A Sebastian; Berweck, Steffen; Borggraefe, Ingo; Van Campenhout, Anja; Andersen, Guro L; Aydin, Resa; Becher, Jules G; Bernert, Guenther; Martinez Caballero, Ignacio; Carr, Lucinda; Valayer, Emmanuelle Chaleat; Desiato, Maria Teresa; Fairhurst, Charlie; Filipetti, Paul; Hassink, Ralph-Ingo; Hustedt, Ulf; Jozwiak, Marek; Kocer, Serdar Ibrahim; Kolanowski, Elisabeth; Kraegeloh-Mann, Ingeborg; Kutlay, Sehim; Maenpaa, Helena; Mall, Volker; McArthur, Paul; Morel, Edith; Papavassiliou, Antigone; Pascual-Pascual, Ignacio; Pedersen, Soren Anker; Plasschaert, Frank S; van der Ploeg, Irene; Remy-Neris, Olivier; Renders, Annelies; Di Rosa, Guiseppe; Steinlin, Maja; Tedroff, Kristina; Vidal Valls, Joan; Viehweger, Elke; Molenaers, Guy

doi:10.1016/j.ejpn.2009.09.005

The updated European Consensus 2009 on the use of Botulinum toxin for children with cerebral palsy

Author:

Heinen, Florian

Desloovere, Kaat ; Schroeder, A Sebastian ; Berweck, Steffen ; Borggraefe, Ingo ; Van Campenhout, Anja ; Andersen, Guro L ; Aydin, Resa ; Becher, Jules G ; Bernert, Guenther ; Martinez Caballero, Ignacio ; Carr, Lucinda ; Valayer, Emmanuelle Chaleat ; Desiato, Maria Teresa ; Fairhurst, Charlie ; Filipetti, Paul ; Hassink, Ralph-Ingo ; Hustedt, Ulf ; Jozwiak, Marek ; Kocer, Serdar Ibrahim ; Kolanowski, Elisabeth ; Kraegeloh-Mann, Ingeborg ; Kutlay, Sehim ; Maenpaa, Helena ; Mall, Volker ; McArthur, Paul ; Morel, Edith ; Papavassiliou, Antigone ; Pascual-Pascual, Ignacio ; Pedersen, Soren Anker ; Plasschaert, Frank S ; van der Ploeg, Irene ; Remy-Neris, Olivier ; Renders, Annelies ; Di Rosa, Guiseppe ; Steinlin, Maja ; Tedroff, Kristina ; Vidal Valls, Joan ; Viehweger, Elke ; Molenaers, Guy

Keywords:

botulinum toxin, cerebral palsy, gross motor function, randomized controlled-trial, upper-limb function, ability classification-system, intrathecal baclofen therapy, a neuromuscular blockade, placebo-controlled trial, manual needle placement, academy-of-neurology, double-blind trial, Science & Technology, Life Sciences & Biomedicine, Clinical Neurology, Pediatrics, Neurosciences & Neurology, Botulinum toxin, Cerebral palsy, GROSS MOTOR FUNCTION, ABILITY CLASSIFICATION-SYSTEM, INTRATHECAL BACLOFEN THERAPY, A NEUROMUSCULAR BLOCKADE, MANUAL NEEDLE PLACEMENT, UPPER-LIMB MOVEMENT, DOUBLE-BLIND, GASTROCNEMIUS-MUSCLE, NITROUS-OXIDE, LOWER-EXTREMITY, Anti-Dyskinesia Agents, Botulinum Toxins, Cerebral Palsy, Consensus, Europe, Humans, 1103 Clinical Sciences, 1109 Neurosciences, 1114 Paediatrics and Reproductive Medicine, Neurology & Neurosurgery, 3209 Neurosciences, 3213 Paediatrics

Abstract:

An interdisciplinary European group of clinical experts in the field of movement disorders and experienced Botulinum toxin users has updated the consensus for the use of Botulinum toxin in the treatment of children with cerebral palsy (CP). A problem-orientated approach was used focussing on both published and practice-based evidence. In part I of the consensus the authors have tabulated the supporting evidence to produce a concise but comprehensive information base, pooling data and experience from 36 institutions in 9 European countries which involves more than 10,000 patients and over 45,000 treatment sessions during a period of more than 280 treatment years. In part II of the consensus the Gross Motor Function Measure (GMFM) and Gross Motor Function Classification System (GMFCS) based Motor Development Curves have been expanded to provide a graphical framework on how to treat the motor disorders in children with CP. This graph is named "CP(Graph) Treatment Modalities - Gross Motor Function" and is intended to facilitate communication between parents, therapists and medical doctors concerning (1) achievable motor function, (2) realistic goal-setting and (3) treatment perspectives for children with CP. The updated European consensus 2009 summarises the current understanding regarding an integrated, multidisciplinary treatment approach using Botulinum toxin for the treatment of children with CP.