TREATMENT OF CHRONIC LIMB SPASTICITY WITH BOTULINUM TOXIN-A

The purpose of this open study was to find out whether botulinum toxin A (BTX-A) relieves the signs and symptoms of chronic limb spasticity. The study comprised 40 patients, aged 12-82 years, with moderate to s evere spasticity of the upper (13) or lower limbs (27) refractory to c onventional physical and medical treatments. Outcome measures were cli nical and blinded videotape assessments of spasticity and motor functi on. Electromyography guided BTX-A injections were given in one or two sessions at total doses averaging 175 U in the upper limb (range 70-27 0 U) and 221 U in the lower limb (range 100-500 U). Thirty four patien ts (85%) derived worthwhile benefit, with improved limb posture and in creased range of passive motion in 31, pain reduction in 28 of 31 with pain, and improved function in 16. Side effects were limited to local and usually mild discomfort from the injections (19), symptomatic loc al weakness (one), and local infection (one). Preliminary experience i ndicates that BTX-A is a promising adjunctive treatment for selected p atients with spasticity.