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Botulinum treatment for post-stroke spasticity: low dose regime
A Viriyavejakul1, R Vachalathiti, N Poungvarin
1Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Summary
Botulinum toxin injections effectively reduce post-stroke spasticity in upper and lower limbs for 3-6 months. This safe and cost-effective therapy significantly improves motor function, balance, and joint mobility while decreasing pain.
Area of Science:
- Neuroscience
- Rehabilitation Medicine
- Pharmacology
Background:
- Post-stroke spasticity is a common and debilitating condition affecting motor function.
- Current treatments for spasticity have limitations, necessitating exploration of alternative therapies.
Purpose of the Study:
- To evaluate the efficacy and safety of botulinum A toxin injections for treating moderate to severe post-stroke spasticity.
- To assess the impact of botulinum toxin on motor function, spasticity, joint mobility, and pain.
Main Methods:
- Twenty-two patients with post-stroke spasticity received intramuscular botulinum toxin injections at 50-100 IU doses.
- Treatment intervals varied from 2 to 6 months, determined by neurologist assessment.
- Patient satisfaction, Ashworth scale, and Fugl-Meyer Sensorimotor Assessment were used for evaluations.
Main Results:
- All patients reported satisfaction with the treatment.
- Significant spasticity reduction was observed within 1-2 weeks, lasting 3-6 months.
- Improvements noted in Ashworth scores (1-1.5 points), Fugl-Meyer scores (motor function, balance), passive range of motion, and joint pain.
Conclusions:
- Botulinum toxin therapy is a safe and effective treatment for chronic post-stroke spasticity in upper and lower extremities.
- The study utilized a lower dosage than typically recommended, suggesting potential for dose optimization.
- High cost remains a significant consideration for this therapeutic option.