The effect of botulinum toxin on hand function after incomplete spinal cord injury at the level of C5/6: a case report.
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.
Richardson
D
D
National Hospital for Neurology and Neurosurgery, Queen Square, London, UK.
Edwards
S
S
Sheean
G L
GL
Greenwood
R J
RJ
Thompson
A J
AJ
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*
D018726:Anti-Dyskinesia Agents; D001905:Botulinum Toxins