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Related Concept Videos

Skeletal Muscle Relaxants: Therapeutic Uses01:31

Skeletal Muscle Relaxants: Therapeutic Uses

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Skeletal muscle relaxants are used to relax muscle tone and alleviate painful muscle contractions. However, the choice of skeletal muscle relaxants depends on the duration of the surgical procedure in order to minimize potential side effects. Skeletal muscle relaxants like neuromuscular blocking agents [NMBAs] are commonly employed as adjuvants alongside general anesthetics in clinical settings. NMBAs are also used to maintain controlled ventilation during surgery of the larynx or pharynx...
477
Directly Acting Muscle Relaxants: Dantrolene and Botulinum Toxin01:26

Directly Acting Muscle Relaxants: Dantrolene and Botulinum Toxin

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Directly acting muscle relaxants like dantrolene and botulinum toxin (BoNT) have distinct mechanisms and applications. Dantrolene, a hydantoin derivative, acts on the ryanodine receptor (RYR1) in skeletal muscle cells. RYR1 are calcium channels present at the sarcoplasmic reticulum membrane. In response to excitation, they release calcium ions from the sarcoplasmic reticulum to the cytosol. Calcium promotes actin-myosin-mediated contraction of muscles.
The binding of dantrolene to the RYR1...
661

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Related Experiment Video

Updated: Jun 15, 2025

Standing Neurophysiological Assessment of Lower Extremity Muscles Post-Stroke
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Botulinum Toxin Type A (BoNT-A) Use for Post-Stroke Spasticity: A Multicenter Study Using Natural Language Processing

María Jesús Antón1, Montserrat Molina2, José Gabriel Pérez3

  • 1Department of Physical Medicine and Rehabilitation, Rio Hortega University Hospital, 47007 Valladolid, Spain.

Toxins
|August 28, 2024
PubMed
Summary
This summary is machine-generated.

A quarter of post-stroke spasticity patients received botulinum toxin type A (BoNT-A) for pain relief, usually a year after stroke. Improved data and early treatment are key for better patient care.

Keywords:
artificial intelligencebotulinum toxin Aelectronic health recordsischemic strokemachine learningnatural language processingpost-stroke spasticity

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Area of Science:

  • Neurology
  • Rehabilitation Medicine
  • Pharmacology

Background:

  • Post-stroke spasticity (PSS) is a common complication affecting patient recovery and quality of life.
  • Effective management of PSS often requires a multimodal approach, including pharmacological and non-pharmacological interventions.
  • Botulinum toxin type A (BoNT-A) is a recognized treatment for focal spasticity, but its real-world utilization patterns in PSS require further description.

Purpose of the Study:

  • To describe the utilization patterns of botulinum toxin type A (BoNT-A) for treating post-stroke spasticity (PSS).
  • To analyze patient demographics, stroke characteristics, and treatment approaches in a real-world setting.
  • To identify factors influencing BoNT-A use and areas for improvement in PSS management.

Main Methods:

  • A multicenter, retrospective study utilizing electronic health records (EHRs) from five Spanish hospitals.
  • Natural language processing (NLP) and machine learning (EHRead® technology) combined with SNOMED CT terminology were employed for data extraction.
  • Analysis included patient demographics, stroke details, BoNT-A treatment timing and indications, and co-treatments for 2190 PSS patients.

Main Results:

  • Of 2190 PSS patients (median age 69, 52.1% male), 25.5% received BoNT-A. The median time to spasticity onset was 205 days and to first BoNT-A injection was 364 days post-stroke.
  • The primary indication for BoNT-A was pain control. Rehabilitation was the most frequent non-pharmacological treatment (95.5%).
  • Only 3.3% of patients had recorded spasticity monitoring scales in their EHRs.

Conclusions:

  • BoNT-A is used in a quarter of PSS patients, primarily for pain management, typically around one year after stroke.
  • Current data highlight a significant delay in BoNT-A treatment initiation and limited use of standardized monitoring scales.
  • Enhancing early treatment strategies, systematic disease monitoring, and improving data documentation in EHRs are critical for optimizing PSS patient care.