Volume 30, Issue 173, July 2026

Effectiveness and indications for Botulinum Toxin Type A Treatment in children and adolescents with Cerebral Palsy - A systematic review

Aleksandra Wyciślok^♦, Weronika Kubiak, Amelia Sobanek, Filip Szewczyk, Erwin Górski, Justyna Koziarska, Jakub Deptuch, Zuzanna Szczerba

Institute of Dentistry of the Central Teaching Hospital of the Medical University of Lodz. ul. Pomorska 251, 92-213 Łódź, Poland

^♦Corresponding author
Aleksandra Wyciślok, Institute of Dentistry of the Central Teaching Hospital of the Medical University of Lodz. ul. Pomorska 251, 92-213 Łódź, Poland

ABSTRACT

Introduction: Botulinum Toxin Type A (BoNT-A) has been the standard treatment for spasticity in children with Cerebral Palsy (CP) for over 30 years. Aim: This review provides an overview of the effectiveness and medical indications for BoNTA treatment in underage patients with Cerebral Palsy. Methods: We searched the literature on electronic databases (January 1997- January 2026), including PubMed and Google Scholar, using the following keywords: Cerebral Palsy (CP); Botulinum Toxin Type A (BoNT-A); spasticity; GMFCS scale; Multi-level treatment; and motor development. Randomized controlled trials (RCTs), meta-analyses, and systematic reviews were included. Results: BoNT-A injections are considered a safe and welltolerated treatment when a minimum interval of three months is maintained between treatment sessions. Successful treatment must be individualized and integrated with intensive physiotherapy and orthotic management. Conclusions: It has been proven that BoNT-A is an effective and safe treatment for muscular spasticity in children with cerebral palsy. It improves grasping function and gait patterns and provides significant pain relief in cases of hip spasms. Treatment goals are dependent on the patients’ GMFCS level, ranging from gait improvement (GMFCS I-III) to pain reduction (GMFCS IV-V), greatly enhancing patients' quality of life.

Keywords: Cerebral Palsy (CP), Botulinum Toxin Type A (BoNT-A), spasticity, multimodal rehabilitation, GMFCS scale, multi-level treatment, motor development

Medical Science, 2026, 30, e127ms3886

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Published: 21 July 2026