A new treatment for the management of cerebral palsy has been launched by Ipsen. The company's botulinum toxin (Dysport) has been used experimentally for the treatment of spasticity in children with cerebral palsy for a number of years and is now licensed for this indication (see p450). A potent neurotoxin, botulinum toxin is a local muscle relaxant, which is injected directly into affected muscles where it acts locally to reduce rigidity. It can be used to help children with cerebral palsy become more mobile, improve their ability to walk and gain greater independence, the company says.
In a press statement issued by Ipsen, Dr Ted Roussounis (consultant in paediatric neurology, Yorkshire regional child development centre, St James's University hospital, Leeds) said: "Once the spastic muscles relax, the children have the possibility of learning how to use their limbs in a normal way."
Speaking on March 10 at the launch of Dysport, Dr Bipin Bhakta (senior lecturer and consultant in rehabilitation medicine, St James's University hospital, Leeds) said that the use of targeted treatments, such as botulinum toxin, was important as this helped to relieve muscle spasm without increasing muscle weakness. Dr Bhakta added that, although in some patients botulinum toxin might only have a modest effect, the ramifications of small improvements in movement were widespread.
Mr Richard Parnell (research manager, Scope [formerly the Spastics Society]) said at the launch: "Scope welcomes the development of safe and effective new treatments for children with cerebral palsy". Botox, a botulinum toxin product supplied by Allergan, has been licensed for use in cerebral palsy since September, 1998.

Cerebral palsy and botulinum toxin

Cerebral palsy (CP) is not a disease or an illness but is defined as a permanent disorder of movement and posture.
It is caused by a change to the immature brain which prevents normal development. Damage may occur before or during birth or in early childhood. The main causes of such damage are complications in childbirth, prematurity or illness during pregnancy. According to Scope, one in every 400 babies in the UK develops CP, the main effect being difficulty in movement. In spastic CP, the affected muscles are permanently tensed.
Botulinum toxin is injected directly into muscle tissue where it is taken up by nerve endings. It acts by preventing the accumulation of acetylcholine at the nerve terminal which in turn reduces muscle contraction.