[Efficacy at six months of the botulinum toxin A in the post-stroke lower limb's muscular overactivity].
OBJECTIVE
Post-stroke hemiplegic patients are often disabled by a muscular overactivity of the lower limb which can be treated by botulinum toxin A (BTX). The aim of this study was to assess the length of this efficiency as expressed by the patient.


METHODS
The study was conducted among consecutive patients with post-stroke hemiplegia, disabled by a distal muscular overactivity of the lower limb. The injection of BTX (Botox Allergan) was given under electrostimulation guidance. Efficiency was assessed by the patient at 1, 3 and 6 months, by means of a three-point scale (absent, real but not enough, very good), on the basis of individual objectives previously defined after the precise description of the symptoms, their type of triggering and their functional impact.


RESULTS
Fifty-seven sessions were conducted in 36 patients. At 1 month, 81% of the sessions were efficient, 39% with very good results. At 6 months, 57% of the sessions were still efficient with 25% of very good results. The best results were observed on the permanent extension of the great toe: the efficiency remained very good at 6 months for 47% of the sessions.


CONCLUSIONS
Having been assessed by the patients on the basis of individual objectives, the good result of the treatment by BTX can persist for more than 6 months. This assessment is partly subjective but is, in clinical use, the main basis for the treatment discussion.
Yelnik
A
A
Service de médecine physique et de réadaptation, groupe hospitalier Lariboisière-F.Widal, 200, rue du faubourg Saint-Denis, 75010, Paris, France. alain.yelnik@lrb.ap-hop-paris.fr
Colle
F
F
Bonan
I
I
Bradai
N
N
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019274:Botulinum Toxins, Type A; D005260:Female; D006429:Hemiplegia / Q000150:complications / Q000209:etiology*; D006801:Humans; D007866:Leg / Q000502:physiology; D008297:Male; D008875:Middle Aged; D009465:Neuromuscular Agents; D017060:Patient Satisfaction; D013035:Spasm / Q000188:drug therapy* / Q000209:etiology; D020521:Stroke / Q000150:complications*; D013997:Time Factors; D016896:Treatment Outcome
D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A