Preparing for Botulinum Toxin Injections

Dr. Lisa Thornton discusses how to prepare for botulinum toxin injections. When it comes to preparing your child for botulinum toxin injections, the first most important thing to remember is to know your child.

• Some children want to know what's going to happen at the doctor's office today, and they want to know it before you even leave home.

• You might want to have that discussion with your child then.

• Other children might not want to know until right before the injection. If that's your child, have this discussion just a few minutes before the injection.

Different doctors give botulinum toxin in different ways.

• Some do it right in the office. In that case, they may use cream to numb up your child's skin before the injection.

• Some doctors may not use cream, and other doctors will want your child to go to sleep for just a few minutes.

• So, you'll want to know which technique your doctor is going to use.

Be sure to let your child know why they're getting botulinum toxin injections. Usually it's done for spasticity, which is stiffness in the muscles, or dystonia, which is uncontrollable muscle movements. Sometimes this spasticity or dystonia interferes with brace fit, comfort, or your child's ability to move and play.

Botulinum toxin can be given in almost any muscle.

• Usually, for children with cerebral palsy, it's given into the big muscles of the legs, specifically the muscles that point the toes down, bend the knees, or make the knees come together too strongly.

• It can also be given in the muscles of the arms so that your child can move their elbow, their wrist, or their fingers more easily.

Usually we use a very thin needle to inject botulinum toxin so it doesn't cause a lot of pain for most kids. But if your child is having mild discomfort after the injections, you can use some over-the-counter pain medication, and that will take care of it.

If your child has had an unpleasant experience in the past or is very afraid of needles, you'll want to have a private discussion with your doctor before the procedure so that you can know the technique that's going to be used. That way you can prepare your child.

You'll want to let your child know that these injections will help relax the muscles. After the injections, there are no restrictions. In fact, the more your child moves and plays, the more the medicine will get into the muscle.