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Cerebral Palsy - Back to News Menu
An out-of-the-botox solution to child palsy
Malathy Iyer
July 20, 2005 - [TIMES NEWS NETWORK] - MUMBAI: Kiara D’Souza’s parents discovered their daughter had a mild formof cerebral palsy when she was in her eighteenth month and had still not taken her first faltering steps.
Cerebral palsy (a movement disorder caused by birth-related brain damage) meant Kiara’s legs muscles were too stiff for normal movement. Over the next nine months, Ryan and Wendy D’Souza took Kiara to many doctors and physiotherapists before they heard of an “unusual medicine’’—botulinum toxin, better known as Botox. “One of the physiotherapists directed us to Ashok Johari, a paediatric orthopaedic surgeon, who told us how Botox’s paralysing mechanism could help Kiara move better,’’ says Wendy.
Today, Botox is known as a beauty tool—an injection that makes wrinkles and crow-feet disappear temporarily. The cosmetic appeal of the toxin has overshadowed its medical use for persons with involuntary muscular movements and twitches, squints, sweaty palms and armpits, and cerebral palsy.
Dr Johari, who is attached to a number of hospitals, including the state-run J J Hospital, has over the last six years, used Botox on more than 1,000 children in various age groups. “The youngest child we gave a Botox injection to was about six months old at Wadia Hospital, but we couldn’t follow up with him as we have no address,’’ says Dr Johari,who admits that he was initially sceptical about treating children with the injection.
“I intensely researched the subject, spoke to many local doctors as well as those in the US and found that they regarded two years as a safe period for children,’’ says Dr Johari. But given the fact that toddlers form habits easily, it was best to intervene early in cases of cerebral palsy. “If a child realises there is a certain stiffness in his, say, right hand, he will stop trying to use it. It’s best to intervene before this realisation sets in.’’
Neurologist Mohit Bhatt, who is attached to the J J and Jaslok hospitals, agrees. “It is now routine to use botulinum injections for children as young as nine months, especially since there are no contra-indications except in pregnant women,’’ says Bhatt, who was among the first doctors to start botulinum injections in the city. Less than a decade later, neurologists, dermatologists and orthopaedics use it regularly.
While most adults require botulinum shots every three to four months, the effect lasts longer on children. In most cases, a one-time shot is more than enough to relax themuscles. Kiara D’Souza is an example, as is Simran Dubbeware from Parbhani. Simran was 18 months old when she got her first and only Botox shot three years ago. Her father, R Dubbeware, a businessman from Parbhani, says his daughter used to walk on tip-toe. “We approached several doctors who advised surgery. When Dr Johari suggested Botox, we came to Mumbai,’’ he says.
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