title: Has botulinum toxin type A a place in the treatment of spasticity in spinal cord injury patients?
abstract: OBJECTIVE
  To present and discuss treatment of severe spasms related to spinal cord injury with botulinum toxin type A.
  
  
  METHODS
  A 2-year follow-up study of an incomplete T12 paraplegic patient, who was reluctant to undergo intrathecal baclofen therapy, presenting severe painful spasms in his lower limbs treated with intramuscular injections of botulinum toxin type A.
  
  
  METHODS
  Department of Physical Medicine and Rehabilitation, Hôpital de Gravelone, Sion, Switzerland.
  
  
  METHODS
  Single patient case report.
  
  
  METHODS
  Spasticity, spasms and pain measured with the modified Ashworth scale, spasm frequency score and visual analogue scale.
  
  
  RESULTS
  Treatment of spasticity with selective intramuscular injections of botulinum toxin type A resulted in subjective and objective improvement.
  
  
  CONCLUSIONS
  Botulinum toxin type A has its place in the treatment of spasticity in spinal cord injury patients. This treatment is expensive and its effect is reversible. It can complement intrathecal baclofen in treating upper limb spasticity in tetraplegic patients. Tolerance does occur to the toxin. Although high doses of the product are well tolerated, the quantity should be tailored to the patient's need. The minimal amount necessary to reach clinical effects should be adhered to and booster doses at short period intervals should be avoided.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Hôpital de Gravelone, CH-1950 Sion, Switzerland.
authors.forename: A T
authors.initials: AT
authors.lastname: Al-Khodairy
authors.forename: C
authors.initials: C
authors.lastname: Gobelet
authors.forename: A B
authors.initials: AB
authors.lastname: Rossier
mesh_terms: D019274:Botulinum Toxins, Type A / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009128:Muscle Spasticity / Q000188:drug therapy*; D009465:Neuromuscular Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D011782:Quadriplegia / Q000150:complications*; D013119:Spinal Cord Injuries / Q000150:complications*; D016896:Treatment Outcome
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A