2004 suplement 2


Volume 13, suplement 2

Interdisciplinary problems of spasticity

Botulinum toxin type A in the treatment of upper limb spasticity following cerebral stroke

Jarosław Sławek1, ANDRZEJ BOGUCKI2
1. Oddziału Neurochirurgii Czynnościowej i Chorób Układu Pozapiramidowego Kliniki Neurochirurgii Akademii Medycznej w Gdańsku
2. Oddział Neurologii Wojewódzkiego Szpitala Specjalistycznego im. Marii Skłodowskiej-Curie w Zgierzu
Postępy Psychiatrii i Neurologii, 2004, suplement 2 (18), 59-64
Keywords: spasticity, botulinum toxin, upper limb


Aim. Botulinum toxin type A (BTX-A) application in the treatment of post-stroke spasticity or the upper limb was presented.

Review. BTX-A is a valuable tool in the treatment of spasticity due to cerebral palsy, cerebral injuries and stroke. Since the first publication in 1989 many open-label uncontrolled trials have evidenced BTX-A efficacy in decreasing muscle tone, associated pain and muscle spasms, increasing the passive range of motions, facilitating the hygiene, dressing, and in same studies also improving the upper limb function. However, placebo-controlled studies published so far have not revealed any clear impact of BTX-A injections on the complex functions of the upper limb. This may result from too strict protocols, insufficient sensitivity of outcome measures, or too late recruitment to the study (the risk of contractions). The treatment goals, best candidate characteristics, common patterns of spasticity with muscles involved, dose ranges, dose modifiers and the technique of infection under EMG guidance are discussed in the article.

Address for correspondence:
Dr Jarosław Sławek, Oddział Neurochirurgii Czynnościowej i Chorób Układu Pozapiramidowego
Kliniki Neurochirurgii Akademii Medycznej, ul. Dębinki 7, 80-211 Gdańsk, tel/fax: (58) 3455888, e-mail: jaroslawek@amg.gda.pl