In November 1993, a Foundation Research Fact Sheet discussed the status of
BOTOX TM in the treatment of the muscle spasticity associated with cerebral
palsy.

In summary of the November 1993 Fact Sheet: BOTOX TM is used to relieve
muscle spasm by blocking the transmission of the nerve impulse to a muscle,
causing the muscle to be weakened or paralyzed. It is administered by fine
needle injection into one or more spastic muscles, usually taking effect
within three days and often lasting three to six months. The relief of
spasticity by BOTOX TM injections is usually followed by an organized
program of physical therapy. BOTOX TM has been approved by the U.S. Food and
Drug Administration for use in specific disorders of the eye and of facial
and neck muscles. It is available to physicians through pharmacies. BOTOX TM
has been undergoing evaluation for relieving the muscle spasticity in the
extremities that is associated with cerebral palsy. Readers are referred to
the November 1993 Foundation Research Fact Sheet for additional background
information.

A number of clinical trials of BOTOX TM for use in relieving limb spasticity
in persons with cerebral palsy have now been completed. The data have been
submitted to the U.S. Food and Drug Administration (FDA) for approval of its
use for this purpose. As of now, the FDA review has not been completed.

At the 1995 Annual Meeting of the American Academy of Cerebral Palsy and
Developmental Medicine, a number of research papers were presented on the
clinical evaluation of BOTOX TM. In general, the results reported were
favorable. There were reports of meaningful improvements in limb positioning
and of some improvement in gait of selected patients; other patients had
minimal results. The persons most likely to benefit were young people, with
no tendon contractures and who do not have significant spasticity of muscles
in the thigh.

Comment: The final story on the use of BOTOX TM is not yet available.
Hopefully, the information submitted to the FDA and the evaluation of those
data will be made available in the near future. In the interim, physicians
are continuing to explore the use of BOTOX TM in muscle spasticity due to
cerebral palsy. Some physicians suggest that a trial of BOTOX TM is a
reasonable way to evaluate what effects selective dorsal rhizotomy may have
on spasticity and on gait. However, we must remember that the basic problem
is lack of muscle coordination, not muscle disease. An improvement in limb
positioning may be the reason for the benefit in gait. Additional
information about the use and availability of BOTOX TM can be obtained by
writing to:

BOTOX TM
Allergan, Inc.
2525 Dupont Drive
Irvine, CA 92715


BOTOX TM UPDATE
http://www.ucpa.org/html/research/botoxupdate.html
BOTOX THERAPY
http://www.southshoreneurologic.com/botox-dystonia/botox-1.html
The Parkinsn List Drug Database
http://www.ionet.net/~jcott/homepage/drugdb/019.html
THE USE OF BOTULINUM-A TOXIN
IN THE MANAGEMENT OF MUSCLE SPASTICITY
http://isnet.is.bgsm.edu/ortho/pub/botox.shtml
Botulinum toxin Type A (Botox)
http://adultpain.nursing.uiowa.edu/Adjuvant/BOTOXtt.HTM
Botox Treatment
http://www.hemikids.org/botox.htm


                                Brightest Blessings
                                       Trisha