Injection technique in paediatric spasticity

Objectives: The intramuscular application of botulinum toxin type A (BoNT/A) is an established treatment option to reduce muscular hyperactivity in children with spasticity. Accurate injection is a prerequisite for efficient and safe treatment with BoNT/A. So far, treatment procedures have not been standardized. This is a review and video demonstration of injection techniques and their suitability in children with spasticity. Methods: Different injection techniques, i.e. manual needle placement as well as guidance by electromyography, electrical stimulation, and ultrasound, are weighted in terms of the clinical…