Clostridium botulinum neurotoxin A (Xeomin) for lower limb spasticity due to cerebral palsy – first line

Cerebral palsy (CP) is a lifelong condition that affects movement and co‐ordination, caused by a problem with the brain that occurs before, during or soon after birth. Symptoms are normally
noticeable during the first two or three years of life. These may include developmental delay, stiffness or floppiness, weak arms or legs, fidgety, jerky, clumsy, random or uncontrolled movements,
problems in walking, swallowing, speaking, and learning disabilities. Most of the children with CP have spasticity which is an increase in muscle tone. It causes degrees of difficulty in moving the body, which may be mild or severe. Effective management of spasticity and other motor problems could be important in preventing functional decline. Although the incidence of CP has remained unchanged in the past four decades but it is expected to rise in the future.
Botulinum toxin type A is a drug that is already in use in the UK for the treatment of a number of disorders including spastic muscular and movement conditions. It acts by selectively blocking the
release of a type of enzyme (acetylcholine) involved in spasticity in the muscle. It is administered directly into the affected muscle, providing a temporary reduction in muscular activity in the injected muscles therefore relieving spasticity. If licensed botulinum neurotoxin type A will offer an additional treatment option for lower limb spasticity in children with cerebral palsy.