Intramuscular injections of botulinum toxin (BT) induce a localized, l
ong-lasting paresis of the target muscle that can be graded by the BT
dose administered and that is free of major side effects. With this pr
ofile, BT can be used for symptomatic treatment of various disorders c
aused by pathological muscle hyperactivities. These disorders occur fr
equently in patients in institutions for neurological rehabilitation.
They are difficult to treat with conventional methods, can cause major
suffering and induce substantial costs for our health care system. In
the present study we therefore sought to delineate the use of BT in r
ehabilitative neurology. Regardless of the etiology of the particular
muscle hyperactivity syndrome, five main indication groups are identif
ied: (1) improvement of function of the hyperactive muscles; (2)relief
of pain in the hyperactive muscles; (3) improvement of patient care;
(4) avoidance of sequelae in joints, tendons, ligaments, and teeth; (5
) various special indications.