We studied the clinical impact of neutralizing antibodies to botulinum toxin A that occurred during long‐term treatment of children between 1993 and 2001. Antibodies were found in high titers in 35 of 110 (31.8%) samples from individual patients. Antibody formation correlated with secondary nonresponse (p < 0.001). The most significant risk factors for antibody formation were the frequency of treatments (p = 0.0001) and the injection of a higher weight‐adapted maximum dose per treatment (p = 0.001).

This study confirms that the vaginal route is increasingly used for hysterectomy in France and that it is the route of choice for benign disorders.

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