title: Early use of Xeomin neurotoxin for local anti-spasticity therapy for pes equines after acquired brain injury (ABI).
abstract: OBJECTIVE
  The acute management of spasticity following ABI is challenging. Contractures can occur during the acute phases of illness. The joints most affected are the shoulders and the ankles.
  
  
  METHODS
  A case study of a 48-year-old female patient who received local chemoneurolytic anti-spasticity therapy following a severe subarachnoid haemorrhage for pes equines deformity is presented to illustrate the role of focal neurotoxin therapy.
  
  
  METHODS
  The increasing spasticity in her legs was observed and could not be effectively treated with oral anti-spasticity agents or intensive physiotherapy. As spasticity increased (Modified Ashworth Scale 4), mobility of the right foot continued to deteriorate, leading to indication for local anti-spasticity treatment with Xeomin neurotoxin. The spastic pes equinus was injected with Xeomin® using a total dose of 150 U.
  
  
  RESULTS
  On the 6th day after injection, a gradual reduction in spasticity was observed in the injected muscle (Modified Ashworth Scale 1-2) and an increasing improvement in joint mobility.
  
  
  CONCLUSIONS
  Early local anti-spasticity treatment with Xeomin is effective treatment. The cost of the intervention would appear to be high, but if one compares it with the costs of conservative treatment, it is not more expensive.
authors.affiliation: University of Cologne, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Lippert-Gruner
authors.forename: O
authors.initials: O
authors.lastname: Svestkova
mesh_terms: D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D001930:Brain Injuries / Q000150:complications* / Q000503:physiopathology; D004863:Equinus Deformity / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008875:Middle Aged; D009128:Muscle Spasticity / Q000188:drug therapy* / Q000503:physiopathology; D009498:Neurotoxins / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D009498:Neurotoxins; D019274:Botulinum Toxins, Type A; C545476:incobotulinumtoxinA