EXPERIENCE OF BOTULINUM TOXIN IN THE MANAGEMENT OF SPASTICITY

Hunters Moor Regional Rehabilitation Centre has used botulinum toxin A to treat spasticity for the past 5 years, treating mainly adults with brain damage acquired from head injury or stroke and using the toxin as part of a multidisciplinary approach to their treatment. In this po pulation botulinum toxin A has demonstrated definite antispastic effec ts and an additional analgesic effect. The toxin is simple and quick t o administer and is a useful addition to other therapies, for example by facilitating physiotherapy treatment, orthosis-fitting and improvem ent of the patient's sitting position. It has few side effects, and ca n produce apposite short-term effects, which is important in recoverab le conditions such as stroke and head injury. Disadvantages include th e short-lived nature of the agent's pharmacological effects and expens e. Nevertheless, early intervention with botulinum toxin A may avoid m any long-term problems. Further research is needed to support this app roach. In particular, carefully controlled studies are needed to clari fy the dose-response relationship for individual muscles.