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Botox therapy for spasticity in children using image guidanceBBotox therapy for spasticity in children using image guidanceBotox therapy for spasticity in children using image guidanceEnglishOtherChild (0-12 years);Teen (13-18 years)NASkeletal muscleProceduresCaregivers Adult (19+)NA2016-03-31T04:00:00ZCandice Sockett, RN(EC), MN:APN;​​​​Michelle Cote, BScN, RN;Joao Amaral, MD10.000000000000051.00000000000001194.00000000000Health (A-Z) - ProcedureHealth A-Z<p>Learn about how Botox thearpy can be used to treat spasticiy in your child.</p><p>Spasticity is a muscle condition characterized by stiff or tight muscles and involuntary muscle movement. It occurs as a side effect of conditions of the nervous system, such as cerebral palsy, traumatic brain injury, stroke, multiple sclerosis and spinal cord injury.</p> <p>Symptoms of spasticity include increased muscle tone, overactive reflexes, involuntary movements, pain, decreased functional abilities and delayed motor development.</p> <p>There are many treatments for spasticity, usually oral medications. However, injections of botulinum toxin (Botox) near the affected muscles have been shown to be quite effective.</p> <h2>Why use Botox for spasticity?</h2> <p>Botox helps relax the muscles by blocking messages from the brain that tell muscles to contract (tighten). Botox injections can help increase mobility, relieve pain, maximize comfort, facilitate muscle growth and ease caregiving.</p> <p>Botox injections are done by interventional radiologists using image guidance.</p><h2>Key points</h2> <ul> <li>Botox is used to increase mobility and maximize comfort in patients suffering from muscle conditions such as spasticity.</li> <li>Your child's muscles may feel tender following the treatment. This is normal. You can give your child pain medication such as <a href="/Article?contentid=62&language=English">acetaminophen</a> if needed.</li> <li>Your child will usually be sedated during the procedure.</li> <li>Be calm and honest, and tell your child what to expect. Children feel less nervous and scared when they are given information about what will happen to them.</li> <li>If your child is severely weak or has allergic reaction, go to the nearest emergency department immediately.</li> </ul><h2>On the day of the Botox injections</h2><p>Arrive at the hospital two hours before the planned time of your child’s procedure. Once you are checked in, your child will be dressed in a hospital gown, weighed and assessed by a nurse. You will also be able to speak to the interventional radiologist who will be doing the Botox muscle injections, and the anaesthetist who will be giving your child medication to make them more comfortable during the procedure.</p><p>During the procedure you will be asked to wait in the surgical waiting area.</p><h2>Your child will have medicine for pain</h2><p>Children are given medicine for treatments that may be frightening, uncomfortable or painful. For Botox muscle injections, most children are given <a href="/Article?contentid=1261&language=English">general anaesthesia</a>.</p><h2>How are Botox injections done?</h2><p>The interventional radiologist uses an ultrasound and muscle stimulator to locate the targeted muscles for injection. Once the muscle is located, a tiny needle is used to inject a small amount of Botox into the muscle. This procedure is repeated for each of the desired muscles.</p><p>Botox muscle injections can take from 60 to 90 minutes, depending on the number of muscles being injected.</p> <figure> <span class="asset-image-title">Botox injection for muscle spasticity</span> <img src="https://assets.aboutkidshealth.ca/akhassets/IMD_spasticity_botox_injection_EN.jpg" alt="Needle inserting Botox into hamstring muscle with spasticity" /> </figure><h2>After the Botox injections</h2> <p>Once the injections are complete, your child will be moved to the recovery area. The interventional radiologist will come and talk to you about the details of the procedure. As soon as your child starts to wake up, a nurse will come and get you. </p> <h2>Going home</h2> <p>Most children will go home within a few hours of 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 purposes.</p> <p>For more details on how to care for your child after muscle Botox injections, please see <a href="/Article?contentid=1226&language=English">Botox therapy for spasticity: Caring for your child at home after the procedure</a>.</p> <h2>What to expect after Botox injections</h2> <p>Botox injections start to work a few days after the treatment. It is most effective one to two weeks after injections, and results gradually wear off after three to six months.</p> <p>Your child may experience muscle soreness or bruising at the injection sites. However, they should not experience any severe pain. <a href="/Article?contentid=62&language=English">Acetaminophen</a> can be given for pain management if needed. After the injections, your child can return to their regular activities and begin wearing their braces again (in children with cerebral palsy).</p><h2>Visiting the clinic before the procedure</h2><p>Your child may have to visit the interventional radiologist one to three weeks before receiving the Botox injections. During the visit, you should expect the following:</p><ul><li>A health assessment to make sure your child is healthy and that it is safe to have general anesthesia.</li><li>An overview of the procedure and a review of the consent form with an interventional radiologist.</li></ul><h2>Giving consent before the procedure</h2><p>Before the procedure, the interventional radiologist will go over how and why the procedure is done, as well as the potential benefits and risks. They will also discuss what will be done to reduce these risks, and will help you weigh any benefits against the risks. It is important that you understand all of these potential risks and benefits of the Botox injections and that all of your questions are answered. If you agree to the procedure, you can give consent for treatment by signing the consent form. A parent or legal guardian must sign the consent form for young children. The procedure will not be done unless you give your consent.</p><h2>How to prepare your child for the procedure</h2><p>Before any treatment, it is important to talk to your child about what will happen. When talking to your child, use words they can understand. Let your child know that medicines will be given to make them feel comfortable during the procedure.</p><p>Children feel less anxious and scared when they know what to expect. Children also feel less worried when they see their parents are calm and supportive.</p><h2>If your child becomes ill within two days before the procedure</h2><p>It is important that your child is healthy on the day of their procedure. If your child starts to feel unwell or has a fever within two days before the Botox injections, let your doctor know. Your child’s procedure may need to be rebooked.</p><h2>Food, drink and medicines before the procedure</h2><ul><li>Your child’s stomach must be empty before receiving the general anesthetic.</li><li>If your child has special needs during fasting, talk to your doctor to make a plan.</li><li>Your child can take their regular morning medicine with a sip of water two hours before the procedure. </li><li>Medicines such as <a href="/Article?contentid=77&language=English">acetylsalicylic acid (ASA)</a>, <a href="/Article?contentid=198&language=English">naproxen</a> or <a href="/Article?contentid=153&language=English">ibuprofen</a>, <a href="/Article?contentid=265&language=English">warfarin</a> or <a href="/Article?contentid=129&language=English">enoxaparin</a> may increase the risk of bleeding. Do not give these to your child before the procedure. If your child is taking any of these medicines, please discuss this with your doctor and the interventional radiologist. </li></ul>​​<h2>At SickKids</h2> <p>At SickKids, the interventional radiologists work in the <a href="http://www.sickkids.ca/diagnosticimaging/what-we-do/image-guided-therapy/index.html" target="_blank">Department of Image-Guided Therapy (IGT)</a>. You can call the IGT clinic at (416) 813-6054 and speak to the clinic nurse during working hours (8:00 to 15:00) or leave a message with the IGT clinic nurse.</p> <p>For more information on fasting see <a href="http://www.sickkids.ca/VisitingSickKids/Coming-for-surgery/Eating-guidelines/index.html" target="_blank">Eating and drinking before surgery</a>.</p> <p>For more information on preparing your child for their procedure see <a href="http://www.sickkids.ca/VisitingSickKids/Coming-for-surgery/index.html" target="_blank">Coming for surgery​</a>.</p>
Thérapie au Botox guidée par imagerie pour le traitement de la spasticité chez les enfantsTThérapie au Botox guidée par imagerie pour le traitement de la spasticité chez les enfantsBotox therapy for spasticity in children using image guidanceFrenchOtherChild (0-12 years);Teen (13-18 years)NASkeletal muscleProceduresCaregivers Adult (19+)NA2016-03-31T04:00:00ZCandice Sockett, RN(EC), MN:APN;​​​​Michelle Cote, BScN, RN;Joao Amaral, MD10.000000000000051.00000000000001194.00000000000Health (A-Z) - ProcedureHealth A-Z<p>Découvrez comment la thérapie au Botox peut être utilisée pour traiter la spasticité chez votre enfant.</p><p>La spasticité est une affection musculaire caractérisée par la raideur ou le blocage des muscles et des mouvements musculaires involontaires. Elle est un effet secondaire des affections du système nerveux comme la paralysie cérébrale, la lésion cérébrale traumatique, l’accident vasculaire cérébral, la sclérose en plaques et la lésion de la moelle épinière.</p> <p>Les symptômes de la spasticité comprennent une augmentation du tonus musculaire, l’hyperréflexie, des mouvements involontaires, la douleur, une diminution des capacités fonctionnelles et le retard du développement moteur.</p> <p>La spasticité peut être traitée de nombreuses manières différentes, généralement à l’aide de médicaments oraux. Cependant, les injections de toxine botulique (de Botox) à proximité des muscles touchés se sont révélées être très efficaces.</p> <h2>Pourquoi utiliser le Botox pour traiter la spasticité?</h2> <p>Le Botox aide à détendre les muscles en bloquant les messages que le cerveau envoie aux muscles afin qu’ils se contractent (se resserrent). Les injections de Botox peuvent aider à augmenter la mobilité, soulager la douleur, maximiser le confort, faciliter la croissance musculaire et l’administration de soins.</p> <p>Les injections de Botox dans les glandes salivaires sont réalisées par des radiologues d’intervention à l’aide de guidage par ultrasons.</p><h2>À retenir</h2> <ul> <li>Le Botox est utilisé pour augmenter la mobilité et maximiser le confort des patients souffrant d’affections musculaires comme la spasticité.</li> <li>Votre enfant pourrait éprouver une sensibilité musculaire après le traitement. C’est normal. Vous pouvez lui donner des médicaments antidouleur comme de l’acétaminophène, si nécessaire.</li> <li>Votre enfant sera généralement sous sédation pendant la procédure.</li> <li>Restez calme et soyez honnête : expliquez à votre enfant à quoi il doit s’attendre. Les enfants sont moins anxieux et ont moins peur quand on leur explique ce qui va se passer.</li> <li>Si votre enfant est très affaibli ou présente une réaction allergique, rendez-vous au service d’urgence le plus proche.</li> </ul><h2>Le jour des injections de Botox</h2><p>Arrivez à l’hôpital deux heures avant l’heure prévue de la procédure. Après son enregistrement, votre enfant devra revêtir une blouse d’hôpital; il sera pesé et son état sera évalué par le personnel infirmier. Vous aurez également l’occasion de parler au radiologue d’intervention qui réalisera les injections de Botox et à l’anesthésiste qui donnera des médicaments à votre enfant pour éviter qu’il soit inconfortable pendant la procédure.</p><p>Au cours de la procédure, vous devrez patienter dans la salle d’attente. </p><h2>Votre enfant recevra des médicaments antidouleur</h2><p>Les enfants reçoivent des médicaments lorsqu’ils subissent une procédure qui peut leur faire peur ou leur causer de l’inconfort ou de la douleur. Pour les injections de Botox dans les muscles, la plupart des enfants reçoivent une <a href="/Article?contentid=1261&language=French">anesthésie générale</a>.</p><h2>Comment procède-t-on aux injections de Botox?</h2><p>Le radiologue d’intervention utilise une machine à ultrasons et un stimulateur musculaire pour localiser les muscles qui feront l’objet des injections. Une fois le muscle trouvé, il y injecte une petite quantité de Botox au moyen d’une petite aiguille. Cette procédure est répétée pour chacun des muscles ciblés.</p><p>Les injections de Botox dans les muscles peuvent prendre de 60 à 90 minutes, en fonction du nombre de muscles ciblés.</p> <figure> <span class="asset-image-title">Injection de Botox pour le traitement de la spasticité musculaire</span><img src="https://assets.aboutkidshealth.ca/akhassets/IMD_spasticity_botox_injection_FR.jpg" alt="Une aiguille injectant de Botox dans la jambe pour traiter la spasticité du muscle ischiojambier" /> </figure><h2>Après les injections de Botox</h2><p>Une fois les injections terminées, votre enfant sera transporté vers la zone de récupération. Le radiologue d’intervention viendra vous donner des détails sur la procédure. Dès que votre enfant commencera à se réveiller, le personnel infirmier viendra vous chercher.</p><h2>Retour à la maison</h2><p>La plupart des enfants rentrent à la maison quelques heures après avoir reçu les injections de Botox. Si votre enfant souffre de problèmes médicaux comme l’apnée du sommeil, vous pourriez être invité à passer la nuit à l’hôpital à des fins d’observation.</p><p>Pour de plus amples renseignements sur la façon de prendre soin de votre enfant après les injections de Botox, veuillez consulter <a href="/Article?contentid=1226&language=French">Injections de Botox pour traiter la spasticité : Prendre soin de votre enfant à la maison après la procédure</a>.</p><h2>À quoi s’attendre après les injections de Botox</h2><p>Vous commencerez à constater les effets des injections de Botox quelques jours après le traitement. Elles sont les plus efficaces une à deux semaines après les injections; leurs résultats disparaîtront progressivement au bout de trois à six mois.</p><p>Votre enfant pourrait ressentir des douleurs musculaires ou présenter des ecchymoses au niveau des sites d’injection. Toutefois, il ne devrait pas éprouver de douleur intense. Vous pouvez administrer de l’<a href="/Article?contentid=62&language=French">acétaminophène</a> à votre enfant afin de l’aider à gérer la douleur, si nécessaire. Après les injections, il pourra reprendre ses activités habituelles et recommencer à porter ses appareils orthopédiques (chez les enfants atteints de paralysie cérébrale).</p><h2>Se rendre à la clinique avant la procédure</h2><p>Votre enfant pourrait avoir à rencontrer le radiologue d’intervention une à trois semaines avant de recevoir les injections de Botox. Lors de cette visite, vous pouvez vous attendre à :</p><ul><li>une évaluation de la santé de votre enfant pour s’assurer qu’il se porte bien et qu’il peut subir une anesthésie générale en toute sécurité;</li><li>une explication de la procédure et un examen du formulaire de consentement avec un radiologue d’intervention.</li></ul><h2>Donner son consentement avant la procédure</h2><p>Avant la procédure, le radiologue d’intervention vous expliquera comment et pourquoi la procédure est effectuée ainsi que les avantages et les risques potentiels qui y sont associés. Il détaillera également les efforts qui seront mis en place pour réduire ces risques, et vous aidera à regarder au-delà des risques afin de réaliser les avantages de la procédure. Il est important que vous compreniez bien tous les risques potentiels et les avantages des injections de Botox et qu’on donne réponse à toutes vos questions. Si vous acceptez que la procédure soit effectuée, vous devrez l’indiquer formellement en signant le formulaire de consentement. Dans le cas de jeunes enfants, le formulaire doit être signé par un parent ou un tuteur légal. La procédure n’aura lieu que si vous donnez votre consentement.</p><h2>Comment préparer votre enfant à la procédure?</h2><p>Avant tout traitement, il est important d’expliquer à l’enfant ce qui va se passer. Ce faisant, utilisez des mots qu’il pourra comprendre clairement. Expliquez-lui qu’il recevra des médicaments afin d’éviter l’inconfort pendant la procédure.</p><p>Les enfants sont moins anxieux et ont moins peur quand ils savent à quoi s’attendre. Ils sont également moins inquiets si leurs parents restent calmes et leur offrent leur soutien.</p><h2>Si votre enfant tombe malade dans les deux jours qui précèdent la procédure</h2><p>Il est important que votre enfant soit en bonne santé le jour de la procédure. S’il commence à se sentir malade ou s’il a de la fièvre dans les deux jours qui précèdent les injections de Botox, informez-en le médecin. Il pourrait être nécessaire de reporter la procédure.</p><h2>Nourriture, boissons et médicaments avant la procédure</h2><ul><li>L’estomac de votre enfant doit être vide avant de recevoir une anesthésie générale.</li><li>Si votre enfant a des besoins particuliers pendant le jeûne, parlez-en à votre médecin afin de planifier son alimentation.</li><li>Votre enfant peut prendre ses médicaments du matin avec une gorgée d’eau, comme d’habitude, deux heures avant la procédure.</li><li>Les médicaments comme l’<a href="/Article?contentid=77&language=French">acide acétylsalicylique (AAS)</a>, le <a href="/Article?contentid=198&language=French">naproxène</a>, ou l'<a href="/Article?contentid=153&language=French">ibuprofène</a>, la <a href="/Article?contentid=265&language=French">warfarine</a> ou l'<a href="/Article?contentid=129&language=French">énoxaparine</a> peuvent augmenter le risque de saignement. Ne les administrez pas à votre enfant avant la procédure. Si votre enfant prend l’un de ces médicaments, veuillez en discuter avec le médecin et avec le radiologue d’intervention.</li></ul>​​​​<h2>À l’hôpital SickKids</h2> <p>À l’hôpital SickKids, les radiologues d’intervention travaillent au <a href="http://www.sickkids.ca/diagnosticimaging/what-we-do/image-guided-therapy/index.html">service de thérapie guidée par imagerie (TGI)</a>. Vous pouvez appeler la clinique de TGI au 416 813-6054 et parler au personnel infirmier de la clinique pendant les heures de travail (de 8 à 15 h) ou lui laisser un message.</p> <p>Pour de plus amples renseignements sur le jeûne, veuillez consulter <a href="http://www.sickkids.ca/VisitingSickKids/Coming-for-surgery/Eating-guidelines/index.html">Manger et boire avant la chirurgie</a>. Pour de plus amples renseignements sur la préparation de votre enfant à la procédure, veuillez consulter <a href="http://www.sickkids.ca/VisitingSickKids/Coming-for-surgery/index.html">Venir à l’hôpital pour une chirurgie​</a>.</p> ​​

 

 

Botox therapy for spasticity in children using image guidance2445.00000000000Botox therapy for spasticity in children using image guidanceBotox therapy for spasticity in children using image guidanceBEnglishOtherChild (0-12 years);Teen (13-18 years)NASkeletal muscleProceduresCaregivers Adult (19+)NA2016-03-31T04:00:00ZCandice Sockett, RN(EC), MN:APN;​​​​Michelle Cote, BScN, RN;Joao Amaral, MD10.000000000000051.00000000000001194.00000000000Health (A-Z) - ProcedureHealth A-Z<p>Learn about how Botox thearpy can be used to treat spasticiy in your child.</p><p>Spasticity is a muscle condition characterized by stiff or tight muscles and involuntary muscle movement. It occurs as a side effect of conditions of the nervous system, such as cerebral palsy, traumatic brain injury, stroke, multiple sclerosis and spinal cord injury.</p> <p>Symptoms of spasticity include increased muscle tone, overactive reflexes, involuntary movements, pain, decreased functional abilities and delayed motor development.</p> <p>There are many treatments for spasticity, usually oral medications. However, injections of botulinum toxin (Botox) near the affected muscles have been shown to be quite effective.</p> <h2>Why use Botox for spasticity?</h2> <p>Botox helps relax the muscles by blocking messages from the brain that tell muscles to contract (tighten). Botox injections can help increase mobility, relieve pain, maximize comfort, facilitate muscle growth and ease caregiving.</p> <p>Botox injections are done by interventional radiologists using image guidance.</p><h2>Key points</h2> <ul> <li>Botox is used to increase mobility and maximize comfort in patients suffering from muscle conditions such as spasticity.</li> <li>Your child's muscles may feel tender following the treatment. This is normal. You can give your child pain medication such as <a href="/Article?contentid=62&language=English">acetaminophen</a> if needed.</li> <li>Your child will usually be sedated during the procedure.</li> <li>Be calm and honest, and tell your child what to expect. Children feel less nervous and scared when they are given information about what will happen to them.</li> <li>If your child is severely weak or has allergic reaction, go to the nearest emergency department immediately.</li> </ul><h2>On the day of the Botox injections</h2><p>Arrive at the hospital two hours before the planned time of your child’s procedure. Once you are checked in, your child will be dressed in a hospital gown, weighed and assessed by a nurse. You will also be able to speak to the interventional radiologist who will be doing the Botox muscle injections, and the anaesthetist who will be giving your child medication to make them more comfortable during the procedure.</p><p>During the procedure you will be asked to wait in the surgical waiting area.</p><h2>Your child will have medicine for pain</h2><p>Children are given medicine for treatments that may be frightening, uncomfortable or painful. For Botox muscle injections, most children are given <a href="/Article?contentid=1261&language=English">general anaesthesia</a>.</p><h2>How are Botox injections done?</h2><p>The interventional radiologist uses an ultrasound and muscle stimulator to locate the targeted muscles for injection. Once the muscle is located, a tiny needle is used to inject a small amount of Botox into the muscle. This procedure is repeated for each of the desired muscles.</p><p>Botox muscle injections can take from 60 to 90 minutes, depending on the number of muscles being injected.</p> <figure> <span class="asset-image-title">Botox injection for muscle spasticity</span> <img src="https://assets.aboutkidshealth.ca/akhassets/IMD_spasticity_botox_injection_EN.jpg" alt="Needle inserting Botox into hamstring muscle with spasticity" /> </figure><h2>After the Botox injections</h2> <p>Once the injections are complete, your child will be moved to the recovery area. The interventional radiologist will come and talk to you about the details of the procedure. As soon as your child starts to wake up, a nurse will come and get you. </p> <h2>Going home</h2> <p>Most children will go home within a few hours of 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 purposes.</p> <p>For more details on how to care for your child after muscle Botox injections, please see <a href="/Article?contentid=1226&language=English">Botox therapy for spasticity: Caring for your child at home after the procedure</a>.</p> <h2>What to expect after Botox injections</h2> <p>Botox injections start to work a few days after the treatment. It is most effective one to two weeks after injections, and results gradually wear off after three to six months.</p> <p>Your child may experience muscle soreness or bruising at the injection sites. However, they should not experience any severe pain. <a href="/Article?contentid=62&language=English">Acetaminophen</a> can be given for pain management if needed. After the injections, your child can return to their regular activities and begin wearing their braces again (in children with cerebral palsy).</p><h2>Visiting the clinic before the procedure</h2><p>Your child may have to visit the interventional radiologist one to three weeks before receiving the Botox injections. During the visit, you should expect the following:</p><ul><li>A health assessment to make sure your child is healthy and that it is safe to have general anesthesia.</li><li>An overview of the procedure and a review of the consent form with an interventional radiologist.</li></ul><h2>Giving consent before the procedure</h2><p>Before the procedure, the interventional radiologist will go over how and why the procedure is done, as well as the potential benefits and risks. They will also discuss what will be done to reduce these risks, and will help you weigh any benefits against the risks. It is important that you understand all of these potential risks and benefits of the Botox injections and that all of your questions are answered. If you agree to the procedure, you can give consent for treatment by signing the consent form. A parent or legal guardian must sign the consent form for young children. The procedure will not be done unless you give your consent.</p><h2>How to prepare your child for the procedure</h2><p>Before any treatment, it is important to talk to your child about what will happen. When talking to your child, use words they can understand. Let your child know that medicines will be given to make them feel comfortable during the procedure.</p><p>Children feel less anxious and scared when they know what to expect. Children also feel less worried when they see their parents are calm and supportive.</p><h2>If your child becomes ill within two days before the procedure</h2><p>It is important that your child is healthy on the day of their procedure. If your child starts to feel unwell or has a fever within two days before the Botox injections, let your doctor know. Your child’s procedure may need to be rebooked.</p><h2>Food, drink and medicines before the procedure</h2><ul><li>Your child’s stomach must be empty before receiving the general anesthetic.</li><li>If your child has special needs during fasting, talk to your doctor to make a plan.</li><li>Your child can take their regular morning medicine with a sip of water two hours before the procedure. </li><li>Medicines such as <a href="/Article?contentid=77&language=English">acetylsalicylic acid (ASA)</a>, <a href="/Article?contentid=198&language=English">naproxen</a> or <a href="/Article?contentid=153&language=English">ibuprofen</a>, <a href="/Article?contentid=265&language=English">warfarin</a> or <a href="/Article?contentid=129&language=English">enoxaparin</a> may increase the risk of bleeding. Do not give these to your child before the procedure. If your child is taking any of these medicines, please discuss this with your doctor and the interventional radiologist. </li></ul><h2>Risks of Botox</h2> <p>Botox is 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 <em>not</em> injected. Unusual reactions have been known to occur within the first few weeks following treatment. These reactions include:</p> <ul> <li><a href="/Article?contentid=30&language=English">fever</a></li> <li>muscle soreness that lasts longer than two days</li> <li>redness or swelling at the injection sites</li> <li>loss of bladder control </li> <li>malaise (generally feeling unwell)</li> </ul> <p>Call your doctor or go to the nearest emergency department if your child is experiencing any of the following symptoms:</p> <ul> <li>severe weakness</li> <li>speech that is becoming more difficult to understand, or voice changes (e.g., hoarse voice)</li> <li>difficulty breathing </li> <li>drooping eyelids or changes in vision </li> <li>allergic reaction (<a href="/Article?contentid=781&language=English">anaphylaxis</a>)</li> </ul> <p>Because Botox has a delayed response, these symptoms usually indicate that Botox has been injected somewhere beyond the targeted muscle.</p>​​<h2>At SickKids</h2> <p>At SickKids, the interventional radiologists work in the <a href="http://www.sickkids.ca/diagnosticimaging/what-we-do/image-guided-therapy/index.html" target="_blank">Department of Image-Guided Therapy (IGT)</a>. You can call the IGT clinic at (416) 813-6054 and speak to the clinic nurse during working hours (8:00 to 15:00) or leave a message with the IGT clinic nurse.</p> <p>For more information on fasting see <a href="http://www.sickkids.ca/VisitingSickKids/Coming-for-surgery/Eating-guidelines/index.html" target="_blank">Eating and drinking before surgery</a>.</p> <p>For more information on preparing your child for their procedure see <a href="http://www.sickkids.ca/VisitingSickKids/Coming-for-surgery/index.html" target="_blank">Coming for surgery​</a>.</p>https://assets.aboutkidshealth.ca/akhassets/IMD_spasticity_botox_injection_EN.jpgBotox therapy for spasticity in children using image guidanceFalse

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