Optimizing Use of Botulinum Toxin Type A for Pediatric Upper Limb Spasticity: Transforming Science Into Clinical Success


Release Date: August 31, 2020 
Last Reviewed: August 31, 2020
Expiration Date: August 31, 2021
Time to Complete Activity: 1.0 hour

Faculty
Katharine Alter, MD

Prince George’s Hospital Center
Cheverly, MD

Jahannaz Dastgir, DO
Director
Pediatric Neuromuscular Medicine Program
Division of Child Neurology
Goryeb Children’s Hospital
Morristown, NJ

Sherry A. Downie, PhD
Professor
Albert Einstein College of Medicine
Bronx, NY
This activity is provided by Paradigm Medical Communications, LLC.   

Target Audience
This activity has been designed to address the educational needs of neurologists, physical medicine and rehabilitation physicians (also known as physiatrists), developmental pediatricians, and orthopedic surgeons. It may also be of benefit to other healthcare providers who are involved in the management of spasticity, including pediatric nurse practitioners and PAs.

Statement of Need
Spasticity is a prevalent disabling consequence of cerebral palsy, the most common motor disability in childhood. Other causes of spasticity in children include traumatic brain injury, multiple sclerosis, spinal cord injury, and stroke. Spasticity can prevent or hamper function, cause pain, disturb sleep, cause unnecessary complications, and present major difficulties for caregivers. Managing upper limb spasticity (ULS) is complex and a major challenge in the rehabilitation of these children. Although treatment with botulinum neurotoxin type A (BoNT-A) is an effective, established first-line adjuvant therapy to physical rehabilitation for the management of spasticity in children, there is considerable variation of its use in practice, without clear standards for providers, leading to variable outcomes. This activity is designed to educate clinicians about the differentiating characteristics of available agents, as well as their optimal use in pediatric ULS, including current methods for ensuring accurate delivery of BoNT-A to the appropriate target muscles.

Learning Objectives
Upon proper completion of this activity, participants should be better able to:
  • Evaluate available BoNT-As, including their mechanisms of action, indications, and preparation, as well as their dosing, efficacy, and safety, in pediatric ULS.
  • Identify the anatomy and pathophysiology of musculature associated with pediatric ULS in which BoNT-As have proven effective in reducing symptoms.
  • Describe current methods for ensuring accurate delivery of BoNT-As to the appropriate target muscles for pediatric ULS.
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Disclosure of Commercial Support
This activity is supported by an educational grant from Allergan, Inc.

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  • View the online activity in its entirety. 
  • Complete and submit the online posttest and evaluation. You must answer 70% of the posttest questions correctly to earn credit. You will have unlimited opportunities to successfully complete the posttest.
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Disclosures
In accordance with ACCME requirements on disclosure, faculty and contributors are asked to disclose any relationships with commercial interests associated with the area of medicine featured in the activity. These relationships are described below.

Katharine Alter, MD
Royalty: Demos Medical Publishing

Jahannaz Dastgir, DO
No financial relationships to disclose.

Sherry A. Downie, PhD
Consulting Fees: Allergan, Inc.
Speakers Bureau: Allergan, Inc.

Paradigm Medical Communications, LLC staff members have no financial relationships to disclose.

Independent peer reviewer, Stephen Nichols, MD, has the following financial relationships to disclose:
Grant/Research Support: Ipsen Biopharmaceuticals, Inc.

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