Botox can be an effective treatment for spasticity and muscle tightness in kids and adolescents with cerebral palsy, though there are risks, according to new guidelines from the American Academy of Neurology and the Child Neurology Society.

The recommendations come even after the Food and Drug Administration warned against using Botox for treatment of cerebral palsy last spring.

After reviewing existing research on treatments for spasticity, the neurology associations report that they found botulinum toxin type A, or Botox, to be generally safe and effective in the new guidelines which will be published Tuesday in the journal Neurology. The groups also recommended the drug diazepam for short term treatment and they mention the drug tizanidine, though it poses a risk of liver toxicity.

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Other treatments lacked sufficient evidence to make a recommendation, the medical groups said.

Spasticity is commonly found in people with cerebral palsy. It is caused by increased muscle tone and those with spasticity typically experience muscle weakness and unusual reflexes.

Though Botox has been used for some time to treat cerebral palsy, the FDA cautioned against the practice last spring following reports of hospitalization and death in some children who underwent the treatment. Botox is typically used to remove wrinkles and is not approved by the FDA for treatment of cerebral palsy.

“There is an urgent need for more research to establish the effectiveness of the current treatments for generalized spasticity and to find additional, safer and more effective medications,” said lead guideline author Mauricio Delgado, a fellow at the American Academy of Neurology.

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