Possible Adverse Effects of Repeated Botulinum Toxin A Injections to Decrease Post-Stroke Spasticity in Adults...

Botulinum toxin A (Botox A) is widely prescribed for the management of spasticity due to stroke, and many patients receive repeated injections because the paralyzing effect diminishes after 3 to 4 months. There are many studies that report local complications of Botox A at the injected site. However, little is known about non-local or systemic adverse events with repeated injections. The purpose of this research was to examine published data about adverse effects of repeated Botox A injections. MEDLINE, CINAHL, and PEDro databases were searched for articles that report adverse effects from Botox A injections for reduction of post-stroke spasticity in adults. Based on studies selected for review, the adverse effects from Botox A injections can be classified into local, systemic, and subclinical types. Systemic and subclinical adverse effects are not commonly reported and need further studies. Therapists and the rehabilitation team need to be aware of the potential of these risk factors that may affect the participation of patients undergoing rehabilitation, and therefore other alternatives to these injections may need to be considered.