title: The effect of botulinum toxin on hand function after incomplete spinal cord injury at the level of C5/6: a case report.
abstract: OBJECTIVE
  To investigate the benefits of the focal use of botulinum toxin in spasticity in the forearm seen after incomplete spinal cord injury.
  
  
  METHODS
  A single case study with standardized assessment before and at three-week intervals after injection.
  
  
  METHODS
  EMG-guided selective injection of botulinum toxin.
  
  
  METHODS
  A 23-year-old man, 18 months post injury.
  
  
  METHODS
  Rivermead Motor Assessment; grip strength; Jebsen hand tests; visual analogue scale; Ashworth spasticity scale.
  
  
  RESULTS
  Weakness was seen as expected with some functional losses, but the patient made gains in the areas of concern: shaking hands, typing, using the hand to drink. These gains were sustained at 12 weeks.
  
  
  CONCLUSIONS
  Selective use of botulinum toxin to weaken muscles can lead to functional benefit.
authors.affiliation: National Hospital for Neurology and Neurosurgery, Queen Square, London, UK.
authors.forename: D
authors.initials: D
authors.lastname: Richardson
authors.forename: S
authors.initials: S
authors.lastname: Edwards
authors.forename: G L
authors.initials: GL
authors.lastname: Sheean
authors.forename: R J
authors.initials: RJ
authors.lastname: Greenwood
authors.forename: A J
authors.initials: AJ
authors.lastname: Thompson
mesh_terms: D000328:Adult; D018726:Anti-Dyskinesia Agents / Q000008:administration & dosage*; D001905:Botulinum Toxins / Q000008:administration & dosage*; D004576:Electromyography; D018737:Hand Strength; D006801:Humans; D015552:Injections, Intralesional; D008297:Male; D009128:Muscle Spasticity / Q000188:drug therapy / Q000209:etiology; D010243:Paralysis / Q000188:drug therapy* / Q000209:etiology; D013119:Spinal Cord Injuries / Q000150:complications / Q000188:drug therapy*
chemical_list: D018726:Anti-Dyskinesia Agents; D001905:Botulinum Toxins