Original ArticlesParent-proxy Ratings of Pain Before and After Botulinum Toxin Type A Treatment for Children With Spasticity and Cerebral PalsyRivard, Patrick F. RN*; Nugent, Andrea C. MPH*; Symons, Frank J. PhD†Author Information *Gillette Children's Specialty Healthcare, Neurodevelopment Pediatrics †Department of Educational Psychology, University of Minnesota, Minneapolis, MN Supported in part by a McKnight Land-Grant Professorship from the University of Minnesota and NICHD grant no. 44763. Reprints: Frank Symons, PhD, Department of Educational Psychology, Education Sciences Building 56 River Road, College of Education and Human Development, University of Minnesota, Minneapolis, MN 55455 (e-mail: [email protected]). Received for publication December 21, 2007; revised July 25, 2008; accepted July 31, 2008 The Clinical Journal of Pain: June 2009 - Volume 25 - Issue 5 - p 413-417 doi: 10.1097/AJP.0b013e31819a6d07 Buy Metrics Abstract Objective To test the hypothesis that pain would be reduced after botulinum toxin type A (Btx/A) treatment for children with cerebral palsy (CP). Method Thirty-four pediatric patients with CP (mean age 9 y; 56% male) and their parents were recruited through a regional specialty healthcare center medical clinic and pain research program. A 1-group pretest, posttest treatment design was used on the basis of a standardized parent-proxy report of their child's pain. Results Overall parent ratings of their child's pain were significantly reduced after Btx/A injection with 62% of parents reporting the absence of pain 1 month after injection (proportion=0.38; 95% confidence interval=0.23-0.55). There were no significant differences for males or females. Conclusions Although there is considerable evidence that Btx/A is efficacious for the treatment of spasticity associated with CP, there is little direct evidence specific to associated analgesic effects after Btx/A treatment. These preliminary findings indicate that Btx/A treatment for spasticity resulted in significant pain reduction for this patient sample. This was the first study to directly ask parents about their child's pain pre-Btx/A and post-Btx/A treatment. These findings have implications for the management of pain associated with spasticity and CP and suggest further research is warranted. © 2009 Lippincott Williams & Wilkins, Inc.