title: Treatment with botulinum toxin type B for upper-limb spasticity.
abstract: 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.
authors.affiliation: Department of Neurology, Indiana University School of Medicine, Indianapolis, IN 46202-5250, USA. abrashea@iupui.edu
authors.forename: Allison
authors.initials: A
authors.lastname: Brashear
authors.forename: Anita L
authors.initials: AL
authors.lastname: McAfee
authors.forename: Elizabeth R
authors.initials: ER
authors.lastname: Kuhn
authors.forename: Walter T
authors.initials: WT
authors.lastname: Ambrosius
mesh_terms: 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
chemical_list: D018726:Anti-Dyskinesia Agents; C096323:rimabotulinumtoxinB; D001905:Botulinum Toxins; D019274:Botulinum Toxins, Type A