Which of the following is a botulinum toxin intervention used in CP?

• A. Hemi-epiphysiodesis
• B. Botulinum toxin injections
• C. Distal femoral extension osteotomy
• D. Selectively dorsal rhizotomy

Answer: (B)

Botulinum toxin injections are a pharmacologic intervention used in cerebral palsy to reduce spasticity in targeted muscles, making it easier to perform therapy, improve range of motion, and assist with gait training. The toxin blocks acetylcholine release at the neuromuscular junction, producing a temporary decrease in muscle tone that lasts several months and can be repeated as needed. This is a focal, non-surgical approach, often guided by EMG or ultrasound to target specific muscles such as calf, hamstrings, or hip adductors.

The other options are surgeries: one alters bone growth to correct deformities, another changes knee alignment to address a flexion contracture, and the last one (a neurosurgical procedure) reduces widespread spasticity by cutting nerve rootlets. Those are not injections, and they address different aspects of CP compared to botulinum toxin.