Treatment with botulinum toxin type B for upper-limb spasticity.
OBJECTIVE
To determine if botulinum toxin type B (MyoBloc) decreases spasticity.


METHODS
Investigator-initiated trial, open-label, single-treatment session.


METHODS
Single site.


METHODS
Ten patients with stable upper-limb spasticity and an Ashworth Scale score of 2 or higher at the elbow, wrist, and fingers.


METHODS
Total dose of 10,000U of botulinum toxin type B injected into 5 major muscles.


METHODS
The Ashworth Scale, goniometry, and functional assessments were performed at injection and weeks 4, 8, and 12. The principal investigator (PI) global assessment of change (GAC) and the patient GAC were done at weeks 4, 8, and 12 postinjection. The safety of the procedure was measured by adverse events and vital signs.


RESULTS
Improvements in Ashworth Scale scores were observed at weeks 4, 8, and 12 postinjection. At week 4, the mean changes (in Ashworth score) were elbow, -1.0 (P=.016); wrist, -1.7 (P=.004); finger, -1.35 (P=.02); at week 8: elbow, -.83 (P=.016); wrist, -1.00 (P=.016); finger, -.94 (P=.08); and at week 12: elbow, -.61 (P=.07); wrist, -1.00 (P=.016); and finger, -.89 (P=.10). The PI GAC improved at all visits. Nine of the 10 subjects reported dry mouth at week 4, with resolution by week 12. No changes were seen on the functional measures.


CONCLUSIONS
Botulinum toxin type B may be useful in treatment of spasticity.
Brashear
Allison
A
Department of Neurology, Indiana University School of Medicine, Indianapolis, IN 46202-5250, USA. abrashea@iupui.edu
McAfee
Anita L
AL
Kuhn
Elizabeth R
ER
Ambrosius
Walter T
WT
D018726:Anti-Dyskinesia Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001905:Botulinum Toxins / Q000009:adverse effects / Q000627:therapeutic use*; D019274:Botulinum Toxins, Type A; D001930:Brain Injuries / Q000534:rehabilitation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009128:Muscle Spasticity / Q000188:drug therapy*; D010865:Pilot Projects; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome
D018726:Anti-Dyskinesia Agents; C096323:rimabotulinumtoxinB; D001905:Botulinum Toxins; D019274:Botulinum Toxins, Type A