BOTULINUM TOXIN TYPE A BOTOX FOR THE TREATMENT OF SPASTICITY OF THE UPPER LIMB IN STROKE PATIENTS
Sposito, M.M.M., MD *; Condratcki, S., Ft.
*Medical Doctor of Escola Paulista de Medicina - Universidade Federal de Sao Paulo/SP - Brazil
Between March/95 and December/96, 27 stroke patients (21 males/6 females) with mean-age 49,74±16,60 years (min 13 / max 72) were treated with BOTOX for periferical block in lower limb. First of all the patients were evaluated clinically, than we took tapes of them, and finely all were protocolated to obtain one score based on: osteotendineos reflex, clonus, activities of daily livings, Ashworth scale, goniometry, and functional activities. By the functional evaluation we could decide the muscles and doses to be used. The most treated muscles were biceps brachialis. All patients were re-evaluated in 20,07±14,39 days (min 5 / max 68) and were followed for 4,12±3,01 months (min 1 / max 12). When we compared the score and the Ashworth scale data among pre proceeding, first pos and final evaluation and analyzed in parametrical and non parametrical bases, all patients improved significantly.
ETHYL ALCOHOL IN THE TREATMENT OF UPPER EXTREMITY SPASTICITY: A PROSPECTIVE STUDY.
KH KONG, KSG CHUA (Tan Tock Seng Hospital, Singapore)
The purpose this study is to evaluate the effectiveness of 50% ethyl alcohol for the procedure of motor point block (MPB) in the treatment of upper extremity spasticity.
Parameters studied included the severity of spasticity as assessed by the modified Ashworth scale (MAS) and joint passive range of motion (PROM).
Sixteen patients underwent MPB - 12 for elbow spasticity and the remaining 4 for wrist and finger spasticity. Etiological diagnoses included stroke (12), spinal cord injury (2) and traumatic brain injury (2). The mean MAS at baseline, 2, 6 and 12 weeks post-MPB were 3.9, 1.7, 1.9 and 2.4 respectively and these differences were statistically significant (p<0.01). Improved PROM were also noted post-treatment.
We conclude that MPB with 50% ethyl alcohol is an effective treatment for upper extremity spasticity.