Botulinum Toxin in Muscular Dystrophies and in Children with Torticollis: A Scoping Review and Case Report

L. Nünlist; S. Grunt; A. Klein

doi:10.1055/s-0045-1812118

Neuropediatrics, Table of Contents

Neuropediatrics 2025; 56(S 01): S1-S24
DOI: 10.1055/s-0045-1812118

Neuromuscular Disorders

Botulinum Toxin in Muscular Dystrophies and in Children with Torticollis: A Scoping Review and Case Report

Authors

L. Nünlist

¹University of Bern, Bern, Switzerland
S. Grunt

²Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland

³Division of Neuropaediatrics, Department of Paediatrics, Development and Rehabilitation, Bern, Switzerland
A. Klein

²Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland

³Division of Neuropaediatrics, Department of Paediatrics, Development and Rehabilitation, Bern, Switzerland

Abstract

Full Text

Background: Botulinum toxin is commonly used to treat movement disorders, but is rarely applied in muscular dystrophies due to concerns about excessive muscle weakening. A clinical case involving a LAMA2-related muscular dystrophy patient showed promising results following botulinum toxin injection, prompting further investigation. The aim of this review was to examine the safety and effectiveness of botulinum toxin injections in two specific populations: children with torticollis and patients with muscular dystrophies. The goal was to explore the existing evidence and potential research gaps of botulinum toxin use as a treatment option in these groups.

Methods: A scoping review according to the PRISMA-ScR guidelines was carried out. Separate searches for both objectives were performed in the database Ovid MEDLINE. All relevant studies published up to December 2024 were screened for eligibility by two people. The data extraction included study characteristics, demographics, disease, and treatment-specific data.

Results: Thirteen studies (227 paediatric torticollis cases) and ten studies (35 muscular dystrophy cases) were included. In the majority of children with torticollis, botulinum toxin improved the range of motion and posture, with few mild side effects. Most cases of muscular dystrophy showed symptom improvement. Rare cases of excessive muscle weakening were reported in association with dysphagia.

Conclusion: Botulinum toxin is a promising and mostly safe treatment in children with torticollis and cases of muscular dystrophy when used cautiously. Further, higher-quality research is required to establish meaningful results suitable for clinical use.