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Long-Term Management of Post-Stroke Spasticity with Botulinum Toxin: A Retrospective Study
Nicoletta Falcone1, Fabrizio Leo2, Carmelo Chisari1
1Department of Traslational Research and New Technologies in Medicine and Surgery, Unit of Neurorehabilitation, University of Pisa, 56126 Pisa, Italy.
Toxins
|September 27, 2024
Summary
Long-term Botulinum Toxin A injections for stroke spasticity show increasing intervals and dosages over time. Early treatment initiation and clear patient goals are crucial for managing this chronic condition effectively.
Area of Science:
- Neurology
- Rehabilitation Medicine
- Pharmacology
Background:
- Stroke-induced spasticity significantly impacts survivors' quality of life.
- Botulinum Toxin A (BoNT-A) is a common treatment, but long-term outcomes are unclear.
- Optimal management strategies for chronic post-stroke spasticity require further investigation.
Purpose of the Study:
- To analyze long-term Botulinum Toxin A treatment patterns in chronic stroke patients.
- To assess treatment duration, dosage variability, and dropout rates.
- To understand the evolution of spasticity management with BoNT-A over extended periods.
Main Methods:
- Retrospective analysis of medical records from 95 chronic stroke patients.
- Inclusion of patients with 2 to 14 years of continuous BoNT-A treatment for spasticity.
- Assessment of demographic data, treatment intervals, dosage adjustments, and reasons for discontinuation.
Main Results:
- A significant extension in the interval between BoNT-A injections was observed over the treatment duration.
- Dropout rates were highest within the first 5 years, potentially linked to perceived ineffectiveness.
- A trend towards escalating BoNT-A dosage was noted across patient groups, suggesting evolving spasticity or treatment response.
- BoNT-A remains the primary treatment for post-stroke spasticity.
Conclusions:
- Long-term BoNT-A treatment for post-stroke spasticity involves dynamic changes in dosage and injection frequency.
- Delayed initiation of BoNT-A treatment highlights the need for increased provider awareness.
- Defining patient expectations and monitoring long-term outcomes are essential for optimizing adherence and managing spasticity effectively.
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