Botox, Children and Fear-Mongering in Journalism

See this article that got my attention here. So obviously, its interesting that people in their 20's are getting cosmetic botox. But, I draw the line at increasing fear in parents with children who need treatment for illness. JR

Dear Sensationalist Journalists,

I am writing a letter to you as journalist who increases the hysteria around pediatric treatments with reckless concern for journalistic integrity. In your article on botulinum toxin treatments, you write about public health warnings about the safety of botox for children. These claims go unchallenged in your article.

Botulinum toxin injections are indicated for the treatment of spasticity based on CLASS A evidence. This level of medical evidence is the highest standard possible and is the type of evidence that also supports antibiotics for pneumonia and other basic medical treatments

The fact is that the weight of medical literature indicates that the use of botulinum toxins in children is safe and without major risk.

Is there risk in life? Of course. Are rare side effects possible? I warmly welcome advisories of such rare side effects. 

Keep in mind that in the US the risk of a fatal car accident in is 1.5 in 10,000 per year. Are the risks of botulinum toxin injections worse than those of the car ride to get them?

Imagine having a child with cerebral palsy. They may have trouble with movement or theri care due to spasticity. Spasticity is disabling, painful and can end in immobilizing, fixed contractures.

How would you treat your own child after reading your article? For spasticity, the options are surgeries, implanted devices and medications. All have higher risks with more unpredictable outcomes.

In the end, parents read your article and those like it and make decisions about the care for their children. Your fear-mongering, built on poor journalistic practices,  creates a barrier to children getting care.

I have included links to peer-reviewed article in major medical journals for your reference

I think a follow up article on the use and safety of this treatment is on order.

Dr. Rotenberg
Child Neurologist

Houston TX

1.

Effectiveness and Safety of Botulinum Toxin Type A in Children with Musculoskeletal Conditions: What Is the Current State of Evidence?

Noémi Dahan-Oliel, Bahar Kasaai, Kathleen Montpetit, Reggie Hamdy

Int J Pediatr. 2012; 2012: 898924. Published online 2012 April 5. doi: 10.1155/2012/898924

PMCID: 

PMC3328151

AbstractFull TextPDF–615K

2.

The use of botulinum toxin A in children with cerebral palsy, with a focus on the lower limb

Guy Molenaers, Anja Van Campenhout, Katrien Fagard, Jos De Cat, Kaat Desloovere

J Child Orthop. 2010 June; 4(3): 183–195. Published online 2010 March 18. doi: 10.1007/s11832-010-0246-x

PMCID: 

PMC2866843

AbstractFull TextPDF–409K

3.

Practice Parameter: Pharmacologic treatment of spasticity in children and adolescents with cerebral palsy (an evidence-based review): Report of the Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society

M R. Delgado, D Hirtz, M Aisen, S Ashwal, D L. Fehlings, J McLaughlin, L A. Morrison, M W. Shrader, A Tilton, J Vargus-Adams

Neurology. 2010 January 26; 74(4): 336–343. doi: 10.1212/WNL.0b013e3181cbcd2f

PMCID: 

PMC3122302

AbstractFull TextPDF–295KSupplementary Material

4.

Botulinum Toxin for Spasticity in Children With Cerebral Palsy: A Comprehensive Evaluation

Kristie Bjornson, Ross Hays, Cathy Graubert, Robert Price, Francine Won, John F. McLaughlin, Morty Cohen

Pediatrics. Author manuscript; available in PMC 2007 July 16.

Published in final edited form as: Pediatrics. 2007 July; 120(1): 49–58. doi: 10.1542/peds.2007-0016

PMCID: 

PMC1920182

AbstractFull TextPDF–323K

See this  quote on Adverse Events

A total of 56 adverse events potentially having any relationship to treatment (injection of BTX-A or saline) were reported during the 6-month study period for both treatment groups. The frequency of adverse events by treatment group (30 = BTX, 26 = placebo) was not significantly different between the groups (p= 0.22). Six of these events required ibuprofen for muscle soreness at injection site (three per treatment group) and three decreased their activity level for 24 hours post injection.