[Botulinum toxin trial for spasticity]

We treated three patients with spastic paraparesis with botulinum toxin (BTX). Two of them had scissors gait reflecting the hypertonus of adductors. In both, an injection of BTX to the responsible muscles improved gait, albeit transiently. The effect was shortlived, probably because increased tonus in non-injected portions compensated for the weakness of injected portions. In the third patient with no abnormality in tonus of the adductors, BTX injection in quadriceps caused a weakness with exacerbation of gait disturbance. We concluded that, in selected cases, BTX therapy is useful for spastic paraparesis to alleviate hypertonicity of the adductors.