Q: My daughter studies in the fifth standard and has cerebral palsy (CP spastic) since birth. She was kept in an incubator after her birth for some days. Now she is unable to walk without any support because she is unable to keep her hind foot on the ground. She crawls on her knees. She can also climb stairs with her knees & hands. She has sharp brain & acts like a normal child. She has stiffness in her ankle area & her left hand seems stiff & weak. She underwent physiotherapy for about 2-3 months, but all in vain. What would be the apt treatment for such a child? Recently we read about botulinum toxin injection role in easing stiffness. Can such a treatment be useful for her?

A:There are few key questions that need to be answered prior to deciding on Botox. Botox is no magic cure and you must remember that Botox therapy without an intensive follow up is of no use at all. Botox relaxes the tight muscles for a period of 6- 8 months when you have to give intensive therapy so that the muscles become strong during that period. Your therapist needs to be very clear as to the aim for giving the botox and you must ask him/her to share it with you and it should be your goal for your child too. No goal can be achieved till the parents are not made partners in planning the goal. Some questions need to be answered prior to saying if botox will help her walk: 1. Is she able to walk with a walker independently presently? 2. Can she come to stand holding on to support independently? If the answers to these questions are yes, then Botox will help her achieve a higher level of mobility status.