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Although no change in quality of life was demonstrated using the AQoL, botulinum toxin type A was found to be safe and efficacious in reducing upper limb spasticity and improving the ability to achieve personal goals.

This study found persistent sympathetic overactivity in response to nociceptive stimuli in dysautonomic subjects (mean, 5 yrs postinjury). This significantly extends the duration over which such sympathetic overactivity has been quantified in this group, contributing to the accumulating empirical evidence that dysautonomic paroxysms result from sympathetic overresponsiveness. Given that sympathetic overactivity has now been observed from day 7 through 5 yrs postinjury, quantitative evaluation of patients for overresponsiveness to stimuli should be added to current diagnostic procedures at all stages of recovery.