Botox injection (intramuscular) for spasticity in children: Caring for your child at home after the procedure

Your child has had Botox injected into some of their muscles for spasticity​. When Botox is injected into the muscles, it helps relax them by blocking messages from the brain that tell the muscles to contract (tighten), hence relaxing them. The information on this page explains how to care for your child at home after the procedure, and when to call for help.

Botox injections in the muscles start to work a few days after the treatment. They are most effective one to two weeks after injections, and results gradually wear off after three to six months. Your child may experience muscle soreness or bruising at the injection sites. However, they should not experience any severe pain.

Discharge from the hospital

Most children will go home one hour after receiving the Botox injections. If your child has any medical conditions such as sleep apnea, you may be asked to spend the night in hospital for observation.

Bathing

Your child may have a bath or shower the day of the injections.

Meals

If your child is feeling well enough after the anaesthetic, they can return to eating what they normally eat. It is also important to give your child plenty of fluids for 48 hours after the procedure.

Pain relief

Your child may have some mild discomfort after the procedure. If needed, give your child acetaminophen for pain.

Activity

Your child can resume all of their regular activities as soon as they feel ready to do so.

When to see a doctor

Botox injections are usually considered safe. However, there is a small possibility that unexpected or unusual reactions to Botox will occur. These reactions may even take place in areas of the body that were not injected. Unusual reactions have been known to occur within the first few weeks following treatment. These reactions include:

• Fever greater than 38°C (100.4°F)
• Muscle soreness that lasts longer than two days
• Redness or swelling at the injection sites
• Loss of bladder control
• Malaise (generally feeling unwell)

Call your child’s doctor or go to the nearest Emergency Department if your child is experiencing any of the following symptoms:

• Severe weakness
• Speech that is becoming more difficult to understand, or changes in voice (e.g., hoarse voice)
• Difficulty breathing
• Drooping eyelids or changes in vision
• Allergic reaction (anaphylaxis) severe pain

Be sure to let the Emergency Department staff know that your child has had Botox injections.

At SickKids

If you have any concerns in the first 48 hours, call the Image Guided Therapy (IGT) clinic at (416) 813- 7654 ext. 201804. Speak to the IGT clinic nurse during working hours or leave a non-urgent message.

If you have concerns and it is after working hours, see your primary care provider or go to the nearest Emergency Department. You can also call the Hospital for Sick Children switchboard at (416) 813-7500 and ask them to page a member of your child’s health-care team or the interventional radiology fellow on call.