All images in this section are for illustration purposes only. Not actual patients or caregivers.

Upper Limb Spasticity (excluding spasticity caused by cerebral palsy) in Pediatrics


  • Cerebral palsy (CP)
  • Traumatic brain injury or spinal cord injury
  • Stroke (ischemic or hemorrhagic)
  • Brain damage caused by oxygen deficiency
  • Multiple sclerosis
  • Encephalitis or meningitis
  • Brain tumor sequelae


  • Muscle stiffness (known as hypertonia)
  • Limited range of movement
  • Reduced ability to relax muscles
  • Muscle spasms
  • Changes in limb position
  • Pain

Common Occurrence after TBI or Stroke4

  • Spasticity may be one of the many possible consequences after a traumatic brain injury (TBI)
  • An estimated 475,000 children between 0–14 years of age sustain a TBI annually
  • In pediatric spasticity, MRI imaging shows damage to or developmental differences in the motor cortex

Clinical Presentation3

Flexed Elbow

Flexed Wrist

Pronated Forearm

Clenched Fist


Michael’s Story*: How XEOMIN Treatment Helped Me

“The upper limb spasticity makes Michael's muscles stiff and sometimes painful, which is so heartbreaking to see. When he began treatment with XEOMIN, he was looser, more comfortable. He was more enthusiastic about activities like painting and cuddling with the dog”
—Sarah, mother of Michael, a pediatric patient with
upper limb spasticity treated with XEOMIN*

Individual results may vary.

Michael, a pediatric patient with upper limb spasticity treated with XEOMIN®.

Now 6 years old, Michael had a traumatic brain injury (TBI) after an accidental fall from the stairs when he was just shy of his first birthday. Sarah, Michael’s mom, noticed early on that he had movement issues. He wasn't sitting on his own, and he wasn’t crawling—he was sensitive and fearful of all movement.

Around his second birthday, he experienced motor difficulties, including increased muscle tone in his left arm and overactive reflexes. Seeing this, Sarah was overwhelmed. It was hard for her to know that her perfect baby was facing some tough physical challenges. When his symptoms didn’t resolve on their own, Sarah became determined to seek help for Michael from his pediatrician, specialists, and wherever else she could find it.

Michael was soon diagnosed with upper limb spasticity. Sarah began treatment for him at an early development rehabilitation center. She was looking for the physical therapist to provide her with a set of tools, a plan to get Michael moving on his own. Most of all, she was looking for hope.

As Sarah continued to explore treatments, she discovered XEOMIN. “With XEOMIN,” she says, “I was concerned that the shots might be stressful for Michael, but he was able to deal with them well. It’s a good thing, because after getting XEOMIN, he had less stiffness and pain. I could see him moving more naturally.” For Sarah, XEOMIN was one more valuable tool she could include in Michael’s toolkit.

Every patient’s experience with XEOMIN will vary, and there are potential risks and side effects with XEOMIN. Talk to your healthcare provider to see if XEOMIN is right for you.

Michael is full of life, spontaneous, and very confident. When Sarah reflects on Michael’s experiences with diagnosis, therapy, and treatment with XEOMIN, what she notices most is how those experiences have added to his character and self-esteem. “When I think of Michael,” she says, “the first thing I think of is his smile. It could light up a town.”*

*Images and fictionalized story are for illustration purposes only. Not an actual patient.


  1. Ward AB. Spasticity treatment with botulinum toxins. J Neural Transm (Vienna). 2008;115(4):607-616. doi: 10.1007/s00702-007-0833-2.
  2. Ozcakir S, Sivrioglu K. Botulinum toxin in poststroke spasticity. Clin Med Res. 2007;5(2):132-138. doi: 10.3121/cmr.2007.716.
  3. American Association of Neurological Surgeons. Spasticity. Accessed June 18, 2021.
  4. Araki T, Yokota H, Morita A. Pediatric Traumatic Brain Injury: Characteristic Features, Diagnosis, and Management. Neurol Med Chir (Tokyo). 2017;57(2):82-93. doi: 10.2176/nmc.ra.2016-0191.