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Botox + serial casting – CP — RACP Paediatrics MCQ

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ModerateNeurologyBotox + serial casting – CPRACP Paediatrics

A 3-year-old with spastic CP (GMFCS III) has bilateral dynamic equinus but NO fixed contractures. Botulinum toxin is being considered. What adjunctive treatment maximises the benefit of botox?

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Correct answer: E — Botulinum toxin + serial casting

Botulinum toxin combined with serial casting maximises the functional benefit. After injection, serial casting (applied 1-2 weeks post-injection) takes advantage of the relaxed muscle to stretch and lengthen it. This combination produces greater range of motion improvement than either intervention alone.

Reference: RCH Melbourne – 2023 – CP CPG; RACP Paediatric Curriculum – Rehabilitation