Anatomical Surface Guided Techniques for Botulinum Toxin Injection in Spastic Cerebral Palsy Children

Abstract

Spasticity, a classical clinical manifestation of an upper motor neuron lesion, has been traditionally and physiologically defined as a velocity-dependent increase in muscle tone caused by the increased excitability of the muscle stretch reflex. Clinically, spasticity manifests as an increased resistance offered by muscles to passive stretching (lengthening) and is often associated with other commonly observed phenomena, such as clasp-knife phenomenon, increased tendon reflexes, clonus, and flexor and extensor spasms. If spasticity is not treated leads to abnormal posture, contracture, and painful deformities. This chapter will cover the botulinum toxin used in the management of spasticity while using the surface anatomy of upper and lower limb muscles. This will help enhance the use of this technique even in remotest setups where USG and EMG facilities are unavailable.