The role of botulinum toxin (type A) in the management of spastic stroke patients

El-Tamawy, Mohamed S.; Abdel-Kader, A.; Shereen, F.; Hatem, Samar; Abo-Krysha, N.; El-Bahrawy, Mohamed N.; Darwish, M.

doi:10.1016/s0035-3787(05)85233-6

Cited by 1 publication

(1 citation statement)

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“…All subjects with PSS were injected BoNT-A (Canitox ® vials) toxin at the first and second visit. The vial contained 100 U diluted with 4 ml of normal saline [15], which was aspirated to a syringe ready to be used. The toxin doses were administered to injected limbs with 100 U/session at the first visit (baseline) and the second visit (after 3-4 weeks).…”

Section: Bont-amentioning

confidence: 99%

Botulinum neurotoxin-A in a patient with post-stroke spasticity: a neurophysiological study

Fawzi,

Hamdan,

Jaafar

et al. 2023

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Introduction: Post-stroke spasticity (PSS) is a disorder of the sensory-motor control, leading to upper motor neuron lesions manifesting either as intermittent or sustained involuntary activation of muscles. Botulinum neurotoxin-A (BoNT-A) is mostly utilized in a variety of therapeutic indications, and it is effective and safe in the management of focal PSS in the rehabilitation scenario. The study aimed to evaluate the effect of BoNT-A administration on H-reflex of upper and lower limbs following PSS. In addition, the investigation of the association among the degree of spasticity (assessed by the Modified Ashworth Scale [MAS]) and motor neuron pool excitability (assessed by analysing H-reflex excitability) was done. Material and methods: Fifty patients with a stroke of either sex aged 30 to 60 years presented with either upper or lower limb focal spasticity were studied. BoNT-A was given on two occasions to the gastrocnemius, soleus, biceps brachii muscles and flexor carpi radialis (FCR). H-reflex was documented from the FCR and soleus muscles at baseline and 3-4 weeks post BoNT-A injection. Medical Research Council scale and MAS were used to assess the PSS and muscle strength.Results: H-reflex latency and amplitude, H/M ratio recorded from FCR and soleus muscles were significantly different between pre-and post-management. The MRC scale was significantly increased whereas the MAS was significantly reduced post BoNT-A injection. Conclusions: BoNT-A causes obvious improvement in PSS clinically as assessed by MAS and MRC scale as well as neurophysiologically by H-reflex. A negative correlation between H-reflex latency but not the amplitude or H max /M max ratio and MAS was observed.

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Section: Bont-amentioning

confidence: 99%