title: The use of botulinum toxin for spasticity after spinal cord injury.
abstract: OBJECTIVE
  To describe the use and effects of botulinum toxin (BTX) injections in persons with spinal cord injury (SCI) and focal spasticity.
  
  
  METHODS
  Chart review of patients with SCI receiving their first injection of BTX for spasticity control at a freestanding urban rehabilitation hospital. Charts were reviewed for history and level of SCI, one of five self-identified goals (ambulation, positioning, upper-extremity function, hygiene, and pain control) before and after injection; site and doses of BTX used; and self-reported outcome on clinical follow-up.
  
  
  RESULTS
  Charts of 28 adults receiving BTX were reviewed. All patients received BTX type A. Dosages of BTX ranged from 10 to 119 units per muscle. Improvement was noted for 56% in ambulation and 71% in positioning. Overall, upper-extremity function improved in 78%, hygiene improved in 66.6%, and pain decreased in 83.3%. Early use of BTX injections (less than a year after onset of symptoms) vs. late use of BTX injections did not influence effectiveness.
  
  
  CONCLUSIONS
  BTX seems to be an effective treatment for focal spasticity and for reducing disability in persons with SCI. Randomized trials are needed to confirm the value of this treatment in the setting of SCI.
authors: Rehabilitation Institute of Chicago, Chicago, Illinois 60611, USA.
authors: Christina
authors: C
authors: Marciniak
authors: Lynn
authors: L
authors: Rader
authors: Christine
authors: C
authors: Gagnon
mesh_terms: D000328:Adult; D000368:Aged; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D006801:Humans; D007273:Injections, Intramuscular; D008875:Middle Aged; D009128:Muscle Spasticity / Q000188:drug therapy* / Q000209:etiology; D009465:Neuromuscular Agents / Q000627:therapeutic use*; D010147:Pain Measurement; D017060:Patient Satisfaction; D020127:Recovery of Function / Q000187:drug effects*; D012189:Retrospective Studies; D013119:Spinal Cord Injuries / Q000150:complications*; D016896:Treatment Outcome
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A