{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T07:44:49Z","timestamp":1792136689139,"version":"4.4.0"},"reference-count":145,"publisher":"SAGE Publications","issue":"1_suppl","license":[{"start":{"date-parts":[[2003,1,1]],"date-time":"2003-01-01T00:00:00Z","timestamp":1041379200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Child Neurol"],"published-print":{"date-parts":[[2003,1]]},"abstract":"<jats:p>Neuromuscular blockade via injection of alcohol, phenol, or botulinum toxin reduces the tone of overactive muscles in order to restore the appropriate balance between agonists and antagonists. Such a restoration allows improved stretch and increased resting length and can reduce the likelihood of contracture. Alcohol or phenol, injected onto the motor nerve, denatures proteins and promotes axonal degeneration. The onset of action is within hours, whereas the duration of action is variable, ranging from 2 weeks to 6 months and beyond. The advantages of alcohol or phenol chemodenervation lie in their low cost and lack of antigenicity. The disadvantages include the technical difficulty of the injections and significant risk for pain as a result of treatment. Botulinum toxins, purified forms of  Clostridium botulinum exotoxins, are injected directly into muscle, where they cleave one or more vesicle fusion proteins, thus blocking release of acetylcholine at the neuromuscular junction. Three commercial products\u2014two of serotype A and one of B\u2014are available. Each differs in its unit potency, side effects, and duration of action. On average, botulinum toxin has a clinical onset of action approximately 12 to 72 hours after injection, with a peak effect at 1 to 3 weeks. Effects then plateau for 1 to 2 months, with patients often requiring reinjection approximately every 3 months. Side effects may include local discomfort at the site of the injection and excessive weakness of the injected or nearby muscles, although more distant effects may occur. Antibody formation is a significant clinical concern and eventually obviates treatment benefit in approximately 5% of patients. Switching serotypes may be effective, at least temporarily. Consensus dosing guidelines have been developed and are presented within. Numerous studies have suggested that botulinum toxin has a role in the care of children with spasticity or dystonia related to cerebral palsy, and may improve equinus, gait, upper extremity use, comfort, and care. Evidence of functional improvement remains equivocal in the severely impaired child; however, there is evidence for improvement in less impaired children. The optimal candidate for injectable neuromuscular blockade is one who has a limited number of muscles that need treatment, who does not have fixed contracture, and who retains selective motor control. The ultimate goal of treatment for the hypertonic child is to maximize function, comfort, and independence. Hypertonia is only one aspect of the upper motoneuron syndrome, which includes both positive and negative symptoms. The treatment program, in which chemodenervation is only one tool, requires a multidisciplinary evaluation and individualized plan to address the whole patient. (J Child Neurol 2003:18:S50\u2014S66).<\/jats:p>","DOI":"10.1177\/0883073803018001s0701","type":"journal-article","created":{"date-parts":[[2017,1,5]],"date-time":"2017-01-05T23:07:11Z","timestamp":1483657631000},"source":"Crossref","is-referenced-by-count":57,"title":["Injectable Neuromuscular Blockade in the Treatment of Spasticity and Movement Disorders"],"prefix":"10.1177","volume":"18","author":[{"given":"Ann H.","family":"Tilton","sequence":"first","affiliation":[{"name":"Department of Neurology, Section of Child Neurology,\rLouisiana State University Health Science Center, New Orleans, LA, atilto@aol.com."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2003,1]]},"reference":[{"key":"e_1_2_1_2_1","doi-asserted-by":"publisher","DOI":"10.1152\/ajplegacy.1928.86.2.312"},{"issue":"1","key":"e_1_2_1_3_1","first-page":"S23","article-title":"Neuromuscular blockade in the management of cerebral palsy","volume":"11","year":"1996","unstructured":"Koman LA, Mooney JF III, Smith BP: Neuromuscular blockade in the management of cerebral palsy. J Child Neurol1996;11(Suppl 1):S23\u2014S28.","journal-title":"J Child Neurol"},{"key":"e_1_2_1_4_1","volume-title":"Traditional Pharmacologic Treatments for Spasticity Part 1: Local Treatments","year":"2002","unstructured":"Gracies JM, Elovic E., McGuire JR, et al: Traditional Pharmacologic Treatments for Spasticity Part 1: Local Treatments. New York, WE MOVE , 2002."},{"key":"e_1_2_1_5_1","first-page":"139","article-title":"Chemical neurolysis using alcohol (alcoholization) in the treatment of spasticity in the hemiplegic. Cah","volume":"41","year":"1993","unstructured":"Pelissier J. , Viel E., Enjalbert M., et al: Chemical neurolysis using alcohol (alcoholization) in the treatment of spasticity in the hemiplegic. CahAnesthesiol1993;41:139\u2014143.","journal-title":"Anesthesiol"},{"key":"e_1_2_1_6_1","first-page":"233","article-title":"Dilute ethyl alcohol: Effect on the sciatic nerve of the mouse","volume":"57","year":"1976","unstructured":"Taylor JJ, Woolsey RM: Dilute ethyl alcohol: Effect on the sciatic nerve of the mouse. Arch Phys Med Rehabil1976;57:233\u2014237.","journal-title":"Arch Phys Med Rehabil"},{"key":"e_1_2_1_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.1980.tb04354.x"},{"key":"e_1_2_1_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005053-191402000-00003"},{"key":"e_1_2_1_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1047-9651(18)30034-2"},{"key":"e_1_2_1_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.1968.tb02940.x"},{"key":"e_1_2_1_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/107110078300400309"},{"key":"e_1_2_1_12_1","doi-asserted-by":"publisher","DOI":"10.1038\/sc.1974.48"},{"key":"e_1_2_1_13_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.sc.3100859"},{"key":"e_1_2_1_14_1","doi-asserted-by":"publisher","DOI":"10.1191\/0269215502cr508oa"},{"key":"e_1_2_1_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/00004356-199912000-00011"},{"key":"e_1_2_1_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-9993(99)90021-7"},{"key":"e_1_2_1_17_1","doi-asserted-by":"publisher","DOI":"10.1053\/apmr.2000.9395"},{"key":"e_1_2_1_18_1","first-page":"733","article-title":"Clinical and functional outcome after alcohol neurolysis of the tibial nerve for ankle-foot spasticity","volume":"15","year":"2001","unstructured":"Chua KS, Kong KH: Clinical and functional outcome after alcohol neurolysis of the tibial nerve for ankle-foot spasticity. Brain Inj2001;15:733\u2014739.","journal-title":"Brain Inj"},{"issue":"6","key":"e_1_2_1_19_1","first-page":"S92","article-title":"Traditional pharmacological treatments for spasticity part II: General and regional treatments","volume":"20","year":"1997","unstructured":"Gracies JM, Nance P., Elovic E., et al. Traditional pharmacological treatments for spasticity part II: General and regional treatments. Muscle Nerve1997;20(Suppl 6):S92\u2014S120.","journal-title":"Muscle Nerve"},{"key":"e_1_2_1_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/0022-510X(65)90060-2"},{"key":"e_1_2_1_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/00002060-199907000-00010"},{"key":"e_1_2_1_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.880190404"},{"issue":"6","key":"e_1_2_1_23_1","first-page":"S61","article-title":"Traditional pharmacological treatments for spasticity part I: Local treatments","volume":"20","year":"1997","unstructured":"Gracies JM, Elovic E., McGuire J., et al: Traditional pharmacological treatments for spasticity part I: Local treatments. Muscle Nerve1997;20(Suppl 6):S61\u2014S91.","journal-title":"Muscle Nerve"},{"key":"e_1_2_1_24_1","first-page":"391","article-title":"Effect of phenol injection into peripheral nerve of rat: Electron microscope studies","volume":"51","year":"1970","unstructured":"Burkel WE, McPhee M.: Effect of phenol injection into peripheral nerve of rat: Electron microscope studies. Arch Phys Med Rehabil1970;51:391\u2014397.","journal-title":"Arch Phys Med Rehabil"},{"key":"e_1_2_1_25_1","first-page":"438","article-title":"Histologic studies in animals after intramuscular neurolysis with phenol","volume":"58","year":"1977","unstructured":"Halpern D.: Histologic studies in animals after intramuscular neurolysis with phenol. Arch Phys Med Rehabil1977;58:438\u2014443.","journal-title":"Arch Phys Med Rehabil"},{"key":"e_1_2_1_26_1","first-page":"160","article-title":"Phenol block of peripheral nerves","volume":"5","year":"1973","unstructured":"Moritz U.: Phenol block of peripheral nerves. Scand J Rehabil Med1973;5:160\u2014163.","journal-title":"Scand J Rehabil Med"},{"key":"e_1_2_1_27_1","first-page":"155","article-title":"Intramuscular neurolysis for spasticity in children","volume":"60","year":"1979","unstructured":"Easton JK, Ozel T., Halpern D.: Intramuscular neurolysis for spasticity in children. Arch Phys Med Rehabil1979;60:155\u2014158.","journal-title":"Arch Phys Med Rehabil"},{"key":"e_1_2_1_28_1","doi-asserted-by":"publisher","DOI":"10.3109\/09638288809164120"},{"key":"e_1_2_1_29_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF03004977"},{"key":"e_1_2_1_30_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.58.2.258"},{"key":"e_1_2_1_31_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.1971.tb03241.x"},{"key":"e_1_2_1_32_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02752218"},{"issue":"5","key":"e_1_2_1_33_1","first-page":"127","article-title":"Spasticity management in the child with spasticity quadriplegia","volume":"8","year":"2001","unstructured":"Gormley ME Jr, Krach L., Piccini L.: Spasticity management in the child with spasticity quadriplegia. Eur J Neurol2001;8(Suppl 5):127\u2014135.","journal-title":"Eur J Neurol"},{"key":"e_1_2_1_34_1","doi-asserted-by":"publisher","DOI":"10.1097\/00002060-199811000-00012"},{"key":"e_1_2_1_35_1","first-page":"265","volume-title":"Chemodenervation with botulinum toxin for spasticity and dystonia: The effects on gaitAdvances in Neurology","year":"2001","unstructured":"O'Brien CFChemodenervation with botulinum toxin for spasticity and dystonia: The effects on gait, in Ruzicka E, Hallett M, Jankovic J (eds): Advances in Neurology, vol. 87. Philadelphia, Lippincott Williams and Wilkins , 2001, 265\u2014269."},{"key":"e_1_2_1_36_1","first-page":"179","article-title":"A new technique of intramuscular phenol neurolysis","volume":"53","year":"1972","unstructured":"DeLateur BJ : A new technique of intramuscular phenol neurolysis . Arch Phys Med Rehabil1972;53:179\u2014181.","journal-title":"Arch Phys Med Rehabil"},{"key":"e_1_2_1_37_1","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1097\/00003086-198205000-00033","article-title":"Current uses of open phenol block for adult acquired spasticity","volume":"165","year":"1982","unstructured":"Garland DE, Lucie RS, Waters RL: Current uses of open phenol block for adult acquired spasticity. Clin Orthop1982;165: 217\u2014222.","journal-title":"Clin Orthop"},{"key":"e_1_2_1_38_1","first-page":"437","article-title":"Treatment of spasticity with intrathecal block with phenol under myelographic controls","volume":"51","year":"1972","unstructured":"Greitz T., Hannerz J., Lindblom U.: Treatment of spasticity with intrathecal block with phenol under myelographic controls. Acta Neurol Scand1972;51(Suppl):437\u2014438.","journal-title":"Acta Neurol Scand"},{"key":"e_1_2_1_39_1","doi-asserted-by":"publisher","DOI":"10.3928\/0147-7447-19800901-10"},{"key":"e_1_2_1_40_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1983.03330380013002"},{"key":"e_1_2_1_41_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2044.1979.tb06305.x"},{"key":"e_1_2_1_42_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-199108000-00027"},{"issue":"16","key":"e_1_2_1_43_1","first-page":"129","article-title":"Botulinum toxin: Historical perspective and potential new indications","year":"1997","unstructured":"Jankovic J. , Brin MF: Botulinum toxin: Historical perspective and potential new indications. Muscle Nerve1997 ;(Suppl 16):129\u2014145.","journal-title":"Muscle Nerve"},{"key":"e_1_2_1_44_1","first-page":"337","article-title":"The development of Botox: Its history and pharmacology","volume":"8","year":"1998","unstructured":"Aoki KR: The development of Botox: Its history and pharmacology. Pain Dig1998;8:337\u2014341.","journal-title":"Pain Dig"},{"key":"e_1_2_1_45_1","first-page":"23784","article-title":"Identification of the nerve terminal targets of botulinum neurotoxin serotypes A, D, and E","volume":"268","year":"1993","unstructured":"Schiavo G., Rossetto O., Catsicas S., et al: Identification of the nerve terminal targets of botulinum neurotoxin serotypes A, D, and E. J Biochem (Tokyo ) 1993;268:23784\u201423787.","journal-title":"J Biochem"},{"key":"e_1_2_1_46_1","first-page":"27","article-title":"Tetanus and botulinum neurotoxins: Turning bad guys into good by research","volume":"399","year":"2001","unstructured":"Rossetto O. , Seveso M., Caccin P., et al: Tetanus and botulinum neurotoxins: Turning bad guys into good by research. Toxicon2001;399:27\u201441.","journal-title":"Toxicon"},{"key":"e_1_2_1_47_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1047-9651(18)30035-4"},{"key":"e_1_2_1_48_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.96.6.3200"},{"key":"e_1_2_1_49_1","first-page":"110","volume-title":"Botulinum toxin type A: PharmacologySpasticity\u2014Etiology, Evaluation, Management and the Role of Botulinium Toxin","year":"2002","unstructured":"Brin M., Aoki KR: Botulinum toxin type A: Pharmacology, in Mayer N, Simpson DM (eds): Spasticity\u2014Etiology, Evaluation, Management and the Role of Botulinium Toxin. New York, WE MOVE, 2002, 110\u2014124."},{"key":"e_1_2_1_50_1","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-199204000-00006"},{"key":"e_1_2_1_51_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-4598(199604)19:4<488::AID-MUS9>3.0.CO;2-8"},{"key":"e_1_2_1_52_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.410380203"},{"key":"e_1_2_1_53_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.53.5.1156"},{"key":"e_1_2_1_54_1","doi-asserted-by":"publisher","DOI":"10.1054\/ijom.2002.0291"},{"key":"e_1_2_1_55_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-510X(00)00439-1"},{"key":"e_1_2_1_56_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.40.2.277"},{"key":"e_1_2_1_57_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.870060210"},{"key":"e_1_2_1_58_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.58.2.232"},{"key":"e_1_2_1_59_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-9993(96)90042-8"},{"key":"e_1_2_1_60_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0012162200000220"},{"key":"e_1_2_1_61_1","first-page":"403","article-title":"Botulinum toxin in the treatment of pain associated with musculoskeletal hyperactivity","volume":"1","year":"1997","unstructured":"Raj PP: Botulinum toxin in the treatment of pain associated with musculoskeletal hyperactivity . Curr Rev Pain1997;1:403\u2014416.","journal-title":"Curr Rev Pain"},{"key":"e_1_2_1_62_1","first-page":"233","volume-title":"Botulinum toxin A for pain and headacheScientific and Therapeutic Aspects of Botulinum Toxin","year":"2002","unstructured":"Brin MF, Binder WJ, Blitzer A., et al: Botulinum toxin A for pain and headache, in Brin MF, Hallett M, Jankovic J (eds): Scientific and Therapeutic Aspects of Botulinum Toxin. New York, Lippincott Williams, and Wilkins, 2002, 233\u2014250."},{"key":"e_1_2_1_63_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.410380206"},{"key":"e_1_2_1_64_1","doi-asserted-by":"publisher","DOI":"10.1097\/00004691-199807000-00003"},{"key":"e_1_2_1_65_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/121.5.977"},{"key":"e_1_2_1_66_1","doi-asserted-by":"publisher","DOI":"10.1002\/1531-8249(200007)48:1<20::AID-ANA5>3.0.CO;2-U"},{"key":"e_1_2_1_67_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-510X(97)00151-2"},{"key":"e_1_2_1_68_1","first-page":"337","article-title":"McGee-Minnith L, Perlmutter JS: Efficacy and safety of a new bulk toxin of botulinum toxin in cervical dystonia: A blinded evaluation","volume":"22","year":"1999","unstructured":"Racette BA, McGee-Minnith L, Perlmutter JS: Efficacy and safety of a new bulk toxin of botulinum toxin in cervical dystonia: A blinded evaluation. Clin Neuropharmacol1999;22:337\u2014339.","journal-title":"Clin Neuropharmacol"},{"key":"e_1_2_1_69_1","first-page":"239","article-title":"Botulinum toxin treatment of spasmodic torticollis","volume":"88","year":"1992","unstructured":"Anderson T. , Rivest J., Stell R., et al: Botulinum toxin treatment of spasmodic torticollis. J R Soc Med1992;88:239\u2014240.","journal-title":"J R Soc Med"},{"issue":"12","key":"e_1_2_1_70_1","first-page":"S29","article-title":"The safety and efficacy of botulinum toxin type B in the treatment of patients with cervical dystonia: Summary of three controlled clinical trials","volume":"55","year":"2000","unstructured":"Lew MF, Brashear A., Factor S.: The safety and efficacy of botulinum toxin type B in the treatment of patients with cervical dystonia: Summary of three controlled clinical trials . Neurology2000; 55(12 Suppl 5):S29\u2014S35.","journal-title":"Neurology"},{"key":"e_1_2_1_71_1","first-page":"1363","article-title":"Evaluation of the therapeutic usefulness of botulinum neurotoxin B, C1, E F compared to the long-lasting type A: Basis for distinct durations of inhibition of exocytosis in central neurons","volume":"278","year":"2002","unstructured":"Foran PG, Mohammed N., Lisk GO, et al: Evaluation of the therapeutic usefulness of botulinum neurotoxin B, C1, E F compared to the long-lasting type A: Basis for distinct durations of inhibition of exocytosis in central neurons. J Biol Chem2002; 278:1363\u20141371.","journal-title":"J Biol Chem"},{"issue":"5","key":"e_1_2_1_72_1","first-page":"21","article-title":"Botulinum toxin type A and other botulinum toxin serotypes: A comparative review of biochemical and pharmacological actions","volume":"8","year":"2001","unstructured":"Aoki KR, Guyer B.: Botulinum toxin type A and other botulinum toxin serotypes: A comparative review of biochemical and pharmacological actions. Eur J Neurol2001;8(Suppl 5):21\u201425.","journal-title":"Eur J Neurol"},{"key":"e_1_2_1_73_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0041-0101(01)00101-5"},{"key":"e_1_2_1_74_1","first-page":"37","article-title":"Clinical utility of botulinum toxin in the treatment of cerebral palsy: Comprehensive review","volume":"16","year":"2000","unstructured":"Edgar T.: Clinical utility of botulinum toxin in the treatment of cerebral palsy: Comprehensive review. J Child Neurol2000;16:37\u201446.","journal-title":"J Child Neurol"},{"issue":"1","key":"e_1_2_1_75_1","first-page":"28","article-title":"Botulinum toxin treatment in cerebral palsy: Evidence for a new option","volume":"248","year":"2001","unstructured":"Kirschner J. , Berweck S., Mall V., et al: Botulinum toxin treatment in cerebral palsy: Evidence for a new option. J Neurol2001; 248(Suppl 1):28\u201430.","journal-title":"J Neurol"},{"key":"e_1_2_1_76_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0966-6362(99)00054-5"},{"key":"e_1_2_1_77_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.1997.tb07408.x"},{"key":"e_1_2_1_78_1","doi-asserted-by":"publisher","DOI":"10.1097\/01241398-199805000-00006"},{"key":"e_1_2_1_79_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0012162299000493"},{"key":"e_1_2_1_80_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0966-6362(99)00012-0"},{"key":"e_1_2_1_81_1","doi-asserted-by":"publisher","DOI":"10.1016\/0966-6362(95)01054-8"},{"key":"e_1_2_1_82_1","doi-asserted-by":"publisher","DOI":"10.1097\/01241398-200001000-00022"},{"key":"e_1_2_1_83_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0012162200000074"},{"key":"e_1_2_1_84_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.1994.tb11864.x"},{"issue":"4","key":"e_1_2_1_85_1","first-page":"S23","article-title":"Objective measurement of clinical findings in the use of botulinum toxin type A in the management of spasticity of children with cerebral palsy","volume":"6","year":"1999","unstructured":"Boyd RN, Graham HK: Objective measurement of clinical findings in the use of botulinum toxin type A in the management of spasticity of children with cerebral palsy . Eur J Neurol1999; 6(Suppl 4):S23\u2014S36.","journal-title":"Eur J Neurol"},{"key":"e_1_2_1_86_1","first-page":"229","article-title":"Management of cerebral palsy with botulinum toxin A: Report of a randomized, double-blind trial","volume":"14","year":"1994","unstructured":"Koman LA, Mooney JF III, Smith BP, et al: Management of cerebral palsy with botulinum toxin A: Report of a randomized, double-blind trial. J Pediatr Orthopaed1994;14:229\u2014303.","journal-title":"J Pediatr Orthopaed"},{"key":"e_1_2_1_87_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0966-6362(99)00037-5"},{"key":"e_1_2_1_88_1","doi-asserted-by":"publisher","DOI":"10.1097\/01241398-199109000-00002"},{"key":"e_1_2_1_89_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.1989.tb04003.x"},{"key":"e_1_2_1_90_1","doi-asserted-by":"publisher","DOI":"10.1093\/ptj\/71.11.813"},{"key":"e_1_2_1_91_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.79.3.271"},{"issue":"2","key":"e_1_2_1_92_1","first-page":"S34","article-title":"Gross Motor Performance Measure for children with cerebral palsy: Study design and preliminary findings","volume":"83","year":"1992","unstructured":"Boyce WF, Gowland C., Rosenbaum PL, et al: Gross Motor Performance Measure for children with cerebral palsy: Study design and preliminary findings. Can J Public Health1992;83(Suppl 2):S34\u2014S40.","journal-title":"Can J Public Health"},{"key":"e_1_2_1_93_1","doi-asserted-by":"publisher","DOI":"10.1097\/01241398-199307000-00013"},{"key":"e_1_2_1_94_1","doi-asserted-by":"publisher","DOI":"10.1097\/01241398-200001000-00022"},{"key":"e_1_2_1_95_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.1994.tb11863.x"},{"issue":"5","key":"e_1_2_1_96_1","first-page":"1","article-title":"Current evidence for the use of botulinum toxin A in the management of children with cerebral palsy: A systematic review","volume":"6","year":"2001","unstructured":"Boyd RN, Hayes RM: Current evidence for the use of botulinum toxin A in the management of children with cerebral palsy: A systematic review. Eur J Neurol2001;6(Suppl 5):1\u201420.","journal-title":"Eur J Neurol"},{"key":"e_1_2_1_97_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1440-1754.1999.00330.x"},{"issue":"5","key":"e_1_2_1_98_1","first-page":"109","article-title":"The effects of botulinum toxin type A and a variable hip abduction orthosis on gross motor function: A randomized controlled trial","volume":"8","year":"2001","unstructured":"Boyd RN, Dobson F., Parrott J., et al: The effects of botulinum toxin type A and a variable hip abduction orthosis on gross motor function: A randomized controlled trial. Eur J Neurol2001;8(Suppl 5):109\u2014119.","journal-title":"Eur J Neurol"},{"key":"e_1_2_1_99_1","first-page":"64","article-title":"Dysport Dose Range Cerebral Palsy Study Group. Botulinum toxin A (Dysport) for the treatment of dynamic equinus spasticity associated with cerebral palsy: Results of a double-blind, placebo-controlled, dose ranging study","volume":"12","year":"2000","unstructured":"Baker R, EuropeanDysport Dose Range Cerebral Palsy Study Group. Botulinum toxin A (Dysport) for the treatment of dynamic equinus spasticity associated with cerebral palsy: Results of a double-blind, placebo-controlled, dose ranging study. Gait Posture2000;12:64\u201465.","journal-title":"Gait Posture"},{"key":"e_1_2_1_100_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.83.6.481"},{"issue":"5","key":"e_1_2_1_101_1","first-page":"50","article-title":"The effect of botulinum toxin A on the functional ability of the child with spastic hemiplegia: A randomized control study","volume":"8","year":"2001","unstructured":"Love SC, Valentine JP, Blair EM, et al: The effect of botulinum toxin A on the functional ability of the child with spastic hemiplegia: A randomized control study. Eur J Neurol2001; 8(Suppl 5):50\u201458.","journal-title":"Eur J Neurol"},{"key":"e_1_2_1_102_1","doi-asserted-by":"publisher","DOI":"10.1016\/0887-8994(94)90123-6"},{"issue":"4","key":"e_1_2_1_103_1","first-page":"47","article-title":"Adductor spasticity in children with cerebral palsy and treatment with botulinum toxin A: The parent's view of functional outcome","volume":"6","year":"1999","unstructured":"Heinen F., Linder M., Mall V., et al: Adductor spasticity in children with cerebral palsy and treatment with botulinum toxin A: The parent's view of functional outcome. Eur J Neurol1999;6(Suppl 4):47\u201457.","journal-title":"Eur J Neurol"},{"key":"e_1_2_1_104_1","doi-asserted-by":"publisher","DOI":"10.1177\/088307380001500402"},{"key":"e_1_2_1_105_1","doi-asserted-by":"publisher","DOI":"10.1067\/mpd.2000.108393"},{"issue":"5","key":"e_1_2_1_106_1","first-page":"145","article-title":"Botulinum toxin A injections in the spastic upper extremity of children with hemiplegia: Child characteristic that predict a positive outcome","volume":"8","year":"2001","unstructured":"Fehlings D. , Rang M., Glazier J., et al: Botulinum toxin A injections in the spastic upper extremity of children with hemiplegia: Child characteristic that predict a positive outcome. Eur J Neurol2001; 8(Suppl 5):145\u2014149.","journal-title":"Eur J Neurol"},{"key":"e_1_2_1_107_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2000-15289"},{"issue":"5","key":"e_1_2_1_108_1","first-page":"150","article-title":"Management of upper limb dysfunction in children with cerebral palsy: A systematic review","volume":"8","year":"2001","unstructured":"Boyd RN, Morris ME, Graham HK: Management of upper limb dysfunction in children with cerebral palsy: A systematic review. Eur J Neurol2001;8(Suppl 5):150\u2014166.","journal-title":"Eur J Neurol"},{"key":"e_1_2_1_109_1","first-page":"169","volume-title":"Medical therapy and botulinum toxin in dystoniaDystonia 3: Advances in Neurology","year":"1998","unstructured":"Jankovic J.: Medical therapy and botulinum toxin in dystonia, in Fahn S, Marsden CD, DeLong M (eds): Dystonia 3: Advances in Neurology , vol. 78. Philadelphia, Lippincott-Raven, 1998, 169\u2014183."},{"issue":"5","key":"e_1_2_1_110_1","first-page":"S15","article-title":"Use of botulinum toxin A in the treatment of cervical dystonia","volume":"55","year":"2000","unstructured":"Comella CL, Jankovic J., Brin MF: Use of botulinum toxin A in the treatment of cervical dystonia. Neurology2000;55(Suppl 5): S15\u2014S21.","journal-title":"Neurology"},{"key":"e_1_2_1_111_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0387-7604(98)00099-0"},{"key":"e_1_2_1_112_1","doi-asserted-by":"publisher","DOI":"10.1016\/0887-8994(89)90039-8"},{"key":"e_1_2_1_113_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1440-1754.1998.00275.x"},{"key":"e_1_2_1_114_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-979757"},{"key":"e_1_2_1_115_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-973721"},{"key":"e_1_2_1_116_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-979765"},{"key":"e_1_2_1_117_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0887-8994(97)00164-1"},{"key":"e_1_2_1_118_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.880171207"},{"key":"e_1_2_1_119_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.46.5.1382"},{"key":"e_1_2_1_120_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.49.1.189"},{"key":"e_1_2_1_121_1","first-page":"581","volume-title":"The use of botulinum toxin in the management of cerebral palsy in pediatric patientsBotulinum and Tetanus Neurotoxins","year":"1993","unstructured":"Koman LA, Mooney JF III, Smith BP: The use of botulinum toxin in the management of cerebral palsy in pediatric patients, in Das-Gupta BR (ed): Botulinum and Tetanus Neurotoxins. New York , Plenum Press, 1993, 581\u2014587."},{"key":"e_1_2_1_122_1","doi-asserted-by":"publisher","DOI":"10.1097\/00019052-199908000-00012"},{"key":"e_1_2_1_123_1","doi-asserted-by":"publisher","DOI":"10.1097\/00002060-200205000-00007"},{"key":"e_1_2_1_124_1","doi-asserted-by":"publisher","DOI":"10.1002\/1531-8257(200101)16:1<100::AID-MDS1021>3.0.CO;2-G"},{"key":"e_1_2_1_125_1","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1995.83.2.0215"},{"issue":"4","key":"e_1_2_1_126_1","first-page":"S37","article-title":"Medium-term response characterisation and risk factor analysis of botulinum toxin type A in the management of spasticity in children with cerebral palsy","volume":"6","year":"1999","unstructured":"Boyd RN, Graham JE, Nattrass GR, et al: Medium-term response characterisation and risk factor analysis of botulinum toxin type A in the management of spasticity in children with cerebral palsy. Eur J Neurol1999;6(Suppl 4):S37\u2014S45.","journal-title":"Eur J Neurol"},{"issue":"4","key":"e_1_2_1_127_1","first-page":"S11","article-title":"The use of botulinum toxin type A in children with cerebral palsy: A retrospective study","volume":"6","year":"1999","unstructured":"Delgado MR : The use of botulinum toxin type A in children with cerebral palsy: A retrospective study. Eur J Neurol1999; 6(Suppl 4): S11\u2014S18.","journal-title":"Eur J Neurol"},{"key":"e_1_2_1_128_1","first-page":"24","article-title":"Treatment of detrusor-sphincter dyssynergia with botulinum A toxin: A double-blind study","volume":"71","year":"1990","unstructured":"Dykstra DD , Sidi AA: Treatment of detrusor-sphincter dyssynergia with botulinum A toxin: A double-blind study. Arch Phys Med Rehabil1990;71:24\u201426.","journal-title":"Arch Phys Med Rehabil"},{"key":"e_1_2_1_129_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200201000-00014"},{"key":"e_1_2_1_130_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.55.9.844"},{"key":"e_1_2_1_131_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.880140711"},{"key":"e_1_2_1_132_1","doi-asserted-by":"publisher","DOI":"10.1159\/000008222"},{"key":"e_1_2_1_133_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.870090216"},{"key":"e_1_2_1_134_1","doi-asserted-by":"publisher","DOI":"10.2165\/00003495-200161130-00004"},{"key":"e_1_2_1_135_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.870130128"},{"issue":"2","key":"e_1_2_1_136_1","first-page":"15","article-title":"Botulinum toxin in the management of children with cerebral palsy: Indications and outcome","volume":"4","year":"1997","unstructured":"Boyd RN, Graham HK: Botulinum toxin in the management of children with cerebral palsy: Indications and outcome. Eur J Neurol1997 ;4(Suppl 2):15\u201422.","journal-title":"Eur J Neurol"},{"issue":"6","key":"e_1_2_1_137_1","first-page":"S181","article-title":"Cerebral palsy: A rational approach to a treatment protocol, and the role of botulinum toxin in treatment","year":"1997","unstructured":"Russman BS , Tilton A., Gormley ME Jr: Cerebral palsy: A rational approach to a treatment protocol, and the role of botulinum toxin in treatment. Muscle Nerve1997; Suppl 6: S181\u2014S193.","journal-title":"Muscle Nerve"},{"key":"e_1_2_1_138_1","first-page":"134","volume-title":"Cerebral palsy: A rational approach to a treatment protocol and the role of botulinum toxin in treatmentSpasticity\u2014 Etiology, Evaluation, Management and the Role of Botulinum Toxin","year":"2002","unstructured":"Russman BS, Tilton AH, Gormley ME Jr: Cerebral palsy: A rational approach to a treatment protocol and the role of botulinum toxin in treatment, in Mayer N, Simpson DM (eds): Spasticity\u2014 Etiology, Evaluation, Management and the Role of Botulinum Toxin. New York, We Move, 2002, 134\u2014142."},{"key":"e_1_2_1_139_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.870120627"},{"key":"e_1_2_1_140_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.48.1.249"},{"key":"e_1_2_1_141_1","doi-asserted-by":"publisher","DOI":"10.1177\/154596839801200101"},{"key":"e_1_2_1_142_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.880160913"},{"key":"e_1_2_1_143_1","doi-asserted-by":"publisher","DOI":"10.1038\/sc.1996.100"},{"key":"e_1_2_1_144_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.45.4.348"},{"key":"e_1_2_1_145_1","doi-asserted-by":"publisher","DOI":"10.1177\/088307380101600112"},{"key":"e_1_2_1_146_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.1997.tb07501.x"}],"container-title":["Journal of Child Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0883073803018001S0701","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0883073803018001S0701","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T20:34:00Z","timestamp":1777494840000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/0883073803018001S0701"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2003,1]]},"references-count":145,"journal-issue":{"issue":"1_suppl","published-print":{"date-parts":[[2003,1]]}},"alternative-id":["10.1177\/0883073803018001S0701"],"URL":"https:\/\/doi.org\/10.1177\/0883073803018001s0701","relation":{},"ISSN":["0883-0738","1708-8283"],"issn-type":[{"value":"0883-0738","type":"print"},{"value":"1708-8283","type":"electronic"}],"subject":[],"published":{"date-parts":[[2003,1]]}}}