[Multidisciplinary therapy for focal spasticity treatment]

For treating focal dystonias and spastic syndromes local intramuscular injections of botulinum toxin type A (BTA) are the method of choice. The therapy aims to reduce disabling dystonic and spastic movement disorders, ease care and personal hygiene, reduce pain, and improve quality of life. With respect to functional improvement from and accuracy of BTA-injection, treatment results in spasticity often profits from electrical or sonographical guidance of BTA injection in addition to active time localized training methods (physio- and occupational therapy). Since we know that only active synapses binds BTA (receptor is located in the acetylcholine vesicle) further therapeutic methods should also be employed to enhance efficacy of BTA, especially casting and splinting electrical stimulation, for muscle activation and regaining of normal length of spastic muscules are recommended. The goals of focal therapy for spasticity should be discussed with the patient and family members to guarantee maximum results from the coordinated multidisciplinary effort of BTA-treatment in disabling spasticity.