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May 06, 2008; 70 (19) Special Articles

Assessment: Botulinum neurotoxin for the treatment of spasticity (an evidence-based review): [RETIRED]

Report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology

D. M. Simpson, J-M Gracies, H. K. Graham, J. M. Miyasaki, M. Naumann, B. Russman, L. L. Simpson, Y. So
First published May 5, 2008, DOI: https://doi.org/10.1212/01.wnl.0000311391.00944.c4
D. M. Simpson
From the Department of Neurology (D.M.S.), Mount Sinai Medical Center, New York, NY; Department of Rehabilitation Medicine (J.-M.G.), CHU Henri Mondor, Créteil, France; Department of Orthopaedic Surgery (H.K.G.), Royal Children’s Hospital, Victoria, Australia; Toronto Western Hospital (J.M.M.), Ontario, Canada; Department of Neurology (M.N.), Klinikum Augsburg, Germany; Shriners Hospital for Children (B.R.), Portland, OR; Jefferson Medical College (L.L.S.), Philadelphia, PA; and Stanford University (Y.S.), CA.
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J-M Gracies
From the Department of Neurology (D.M.S.), Mount Sinai Medical Center, New York, NY; Department of Rehabilitation Medicine (J.-M.G.), CHU Henri Mondor, Créteil, France; Department of Orthopaedic Surgery (H.K.G.), Royal Children’s Hospital, Victoria, Australia; Toronto Western Hospital (J.M.M.), Ontario, Canada; Department of Neurology (M.N.), Klinikum Augsburg, Germany; Shriners Hospital for Children (B.R.), Portland, OR; Jefferson Medical College (L.L.S.), Philadelphia, PA; and Stanford University (Y.S.), CA.
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H. K. Graham
From the Department of Neurology (D.M.S.), Mount Sinai Medical Center, New York, NY; Department of Rehabilitation Medicine (J.-M.G.), CHU Henri Mondor, Créteil, France; Department of Orthopaedic Surgery (H.K.G.), Royal Children’s Hospital, Victoria, Australia; Toronto Western Hospital (J.M.M.), Ontario, Canada; Department of Neurology (M.N.), Klinikum Augsburg, Germany; Shriners Hospital for Children (B.R.), Portland, OR; Jefferson Medical College (L.L.S.), Philadelphia, PA; and Stanford University (Y.S.), CA.
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J. M. Miyasaki
From the Department of Neurology (D.M.S.), Mount Sinai Medical Center, New York, NY; Department of Rehabilitation Medicine (J.-M.G.), CHU Henri Mondor, Créteil, France; Department of Orthopaedic Surgery (H.K.G.), Royal Children’s Hospital, Victoria, Australia; Toronto Western Hospital (J.M.M.), Ontario, Canada; Department of Neurology (M.N.), Klinikum Augsburg, Germany; Shriners Hospital for Children (B.R.), Portland, OR; Jefferson Medical College (L.L.S.), Philadelphia, PA; and Stanford University (Y.S.), CA.
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M. Naumann
From the Department of Neurology (D.M.S.), Mount Sinai Medical Center, New York, NY; Department of Rehabilitation Medicine (J.-M.G.), CHU Henri Mondor, Créteil, France; Department of Orthopaedic Surgery (H.K.G.), Royal Children’s Hospital, Victoria, Australia; Toronto Western Hospital (J.M.M.), Ontario, Canada; Department of Neurology (M.N.), Klinikum Augsburg, Germany; Shriners Hospital for Children (B.R.), Portland, OR; Jefferson Medical College (L.L.S.), Philadelphia, PA; and Stanford University (Y.S.), CA.
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B. Russman
From the Department of Neurology (D.M.S.), Mount Sinai Medical Center, New York, NY; Department of Rehabilitation Medicine (J.-M.G.), CHU Henri Mondor, Créteil, France; Department of Orthopaedic Surgery (H.K.G.), Royal Children’s Hospital, Victoria, Australia; Toronto Western Hospital (J.M.M.), Ontario, Canada; Department of Neurology (M.N.), Klinikum Augsburg, Germany; Shriners Hospital for Children (B.R.), Portland, OR; Jefferson Medical College (L.L.S.), Philadelphia, PA; and Stanford University (Y.S.), CA.
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L. L. Simpson
From the Department of Neurology (D.M.S.), Mount Sinai Medical Center, New York, NY; Department of Rehabilitation Medicine (J.-M.G.), CHU Henri Mondor, Créteil, France; Department of Orthopaedic Surgery (H.K.G.), Royal Children’s Hospital, Victoria, Australia; Toronto Western Hospital (J.M.M.), Ontario, Canada; Department of Neurology (M.N.), Klinikum Augsburg, Germany; Shriners Hospital for Children (B.R.), Portland, OR; Jefferson Medical College (L.L.S.), Philadelphia, PA; and Stanford University (Y.S.), CA.
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Y. So
From the Department of Neurology (D.M.S.), Mount Sinai Medical Center, New York, NY; Department of Rehabilitation Medicine (J.-M.G.), CHU Henri Mondor, Créteil, France; Department of Orthopaedic Surgery (H.K.G.), Royal Children’s Hospital, Victoria, Australia; Toronto Western Hospital (J.M.M.), Ontario, Canada; Department of Neurology (M.N.), Klinikum Augsburg, Germany; Shriners Hospital for Children (B.R.), Portland, OR; Jefferson Medical College (L.L.S.), Philadelphia, PA; and Stanford University (Y.S.), CA.
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Full PDF
Citation
Assessment: Botulinum neurotoxin for the treatment of spasticity (an evidence-based review): [RETIRED]
Report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology
D. M. Simpson, J-M Gracies, H. K. Graham, J. M. Miyasaki, M. Naumann, B. Russman, L. L. Simpson, Y. So
Neurology May 2008, 70 (19) 1691-1698; DOI: 10.1212/01.wnl.0000311391.00944.c4

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Abstract

Objective: To perform an evidence-based review of the safety and efficacy of botulinum neurotoxin (BoNT) in the treatment of adult and childhood spasticity.

Methods: A literature search was performed including MEDLINE and Current Contents for therapeutic articles relevant to BoNT and spasticity. Authors reviewed, abstracted, and classified articles based on American Academy of Neurology criteria (Class I–IV).

Results: The highest quality literature available for the respective indications was as follows: adult spasticity (14 Class I studies); spastic equinus and adductor spasticity in pediatric cerebral palsy (six Class I studies).

Recommendations: Botulinum neurotoxin should be offered as a treatment option for the treatment of spasticity in adults and children (Level A).

RATIONALE FOR RETIREMENT

The 2008 AAN guideline “Botulinum neurotoxin for the treatment of spasticity” has been retired by the Guideline Development, Dissemination, and Implementation Subcommittee on February 23, 2018, due to this guideline not having been updated or reaffirmed in five years or less after the previous publication or reaffirmation, per the Board of Directors-approved automatic retirement policy, which mandates that all guidelines that fit this criteria will be will be retired automatically unless an update is identified and initiated. The recommendations and conclusions in all retired guidelines are considered no longer valid and no longer supported by the AAN. Retired guidelines will remain available on our website for reference use only. If you would like more information on this guideline or the guideline process, please email guidelines{at}aan.com.

Letters: Rapid online correspondence

  • Assessment: Botulinum neurotoxin for the treatment of spasticity (an evidence-based review)
    • Bruce H. Dobkin, MD, University of California Los Angeles, Dept of Neurology, RNRC, 710 Westwood Plaza, Los Angeles, CA 90095bdobkin@mednet.ucla.edu
    Submitted February 11, 2009
  • Assessment: Botulinum neurotoxin for the treatment of spasticity (an evidence-based review)
    • William M. Landau, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8030 ,St. Louis, MO 63110landauw@neuro.wustl.edu
    • Shirley Sahrmann, PhD; W. Thomas Thach, MD
    Submitted February 11, 2009
  • Reply from the authors
    • David M. Simpson, Mount Sinai Medical Center, One Gustave L. Levy Place, Box 1052, New York, NY 10029david.simpson@mssm.edu
    • John-Michel Gracies, Kerr Graham, Mark Hallett, Janis Miyasaki, Markus Naumann, Barry Russman, Lance Simpson, and Yuen So
    Submitted February 11, 2009
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