Effect of intramuscular botulinum toxin injection on upper limb spasticity in stroke patients.
OBJECTIVE
To evaluate the therapeutic effect of intramuscular injection of botulinum toxin on spasticity of the upper limb, with emphasis on its influence over limb function.


METHODS
An open-label, noncontrolled trial with a duration of 12 wk was designed to determine the safety and efficacy of intramuscular botulinum toxin A injection in the treatment of 16 patients with stroke with spastic hemiparesis. Electromyographically guided intramuscular botulinum toxin A injections were applied to the spastic limbs. A detailed scale system was used for the evaluation of muscle tone and functional changes induced by botulinum toxin A treatment.


RESULTS
No major side effect secondary to botulinum toxin A injection was reported. Statistically significant (P < 0.05) improvements of muscle tone, joint range of motion, hand muscle strength, and muscular pain were seen after the injection. The improvements lasted up to 8-12 wk after the treatment. However, there was no significant functional improvement except in two of the patients.


CONCLUSIONS
Botulinum toxin A injection may help relieve upper limb spasticity and pain in patients with stroke. Its effect on function is probably determined by case selection.
Wang
Han-Cheng
HC
Department of Neurology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan, Republic of China.
Hsieh
Lin-Fen
LF
Chi
Wen-Chou
WC
Lou
Shih-Min
SM
D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D001132:Arm; D019274:Botulinum Toxins, Type A / Q000494:pharmacology / Q000627:therapeutic use*; D005260:Female; D018737:Hand Strength; D006801:Humans; D007273:Injections, Intramuscular; D008297:Male; D008875:Middle Aged; D009465:Neuromuscular Agents / Q000494:pharmacology / Q000627:therapeutic use*; D020336:Paraparesis, Spastic / Q000188:drug therapy* / Q000209:etiology; D016059:Range of Motion, Articular / Q000187:drug effects; D018709:Statistics, Nonparametric; D020521:Stroke / Q000150:complications; D000071939:Stroke Rehabilitation
D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A