Pharmacologic treatment of spasticity in children and adolescents with cerebral palsy
Mary AnneWhelan, PhD, MD, Cerebral Palsy of Upstate New York, 122 Sugar Hill Rd., Cooperstown, NY 13326mawhelan@hughes.net
Submitted May 17, 2010
Delgado et al.'s recent Practice Parameter on the treatment of spasticity [1]
omitted an important review on the use of Botulinum toxin
A, which concluded that "there is moderate evidence that Bo-NT-A alone is not effective." [2] This is a less favorable
conclusion than that offered in the Practice Parameter. Attention
was called to this article in the review process prior to the Practice Parameter publication. In addition, the several, and not insubstantial,
affiliations of the authors would also appear
to be in conflict with articulated AAN policy.
References
1. Delgado MR, Hirtz D, Aisen M, et al. Practice
Parameter: Pharmacologic treatment of spasticity in children
and adolescents with cerebral palsy (an evidence-based
review). Neurology 2010;74:336-343.
2. Hoare BJ, Wallen MA, Imms C, Villanueva E, Rawicki HB, Carey L. Botulinum A as an adjunct to treatment
in the management of the upper limb in children with spastic
cerebral palsy (update). Cochrane Database of systematic
reviews 2010 Issue 1, Art. # CD 003469 (publ online 2004).
Disclosure: Dr. Whelan is on the Editorial Board for the Journal of Child Neurology.
Delgado et al.'s recent Practice Parameter on the treatment of spasticity [1] omitted an important review on the use of Botulinum toxin A, which concluded that "there is moderate evidence that Bo-NT-A alone is not effective." [2] This is a less favorable conclusion than that offered in the Practice Parameter. Attention was called to this article in the review process prior to the Practice Parameter publication. In addition, the several, and not insubstantial, affiliations of the authors would also appear to be in conflict with articulated AAN policy.
References
1. Delgado MR, Hirtz D, Aisen M, et al. Practice Parameter: Pharmacologic treatment of spasticity in children and adolescents with cerebral palsy (an evidence-based review). Neurology 2010;74:336-343.
2. Hoare BJ, Wallen MA, Imms C, Villanueva E, Rawicki HB, Carey L. Botulinum A as an adjunct to treatment in the management of the upper limb in children with spastic cerebral palsy (update). Cochrane Database of systematic reviews 2010 Issue 1, Art. # CD 003469 (publ online 2004).
Disclosure: Dr. Whelan is on the Editorial Board for the Journal of Child Neurology.