Antispastic therapy with botulinum toxin type A in patients with traumatic spinal cord lesion

• Main Authors: Spiegl, Ulrich J., Maier, Doris, Gonschorek, Oliver, Heyde, Christoph-Eckhard, Bühren, Volker
• Format: Article
• Language: deu
• Published: German Medical Science GMS Publishing House 2014-12-01
• Series: GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW
• Subjects: botulinum toxin; spacticity; traumatic spinal cord lesion
• Online Access: http://www.egms.de/static/en/journals/iprs/2014-3/iprs000055.shtml

Objectives: The purpose of this study was to determine the effect of botulinum toxin injections for the treatment of spasticity after traumatic spinal cord injury. Methods: 9 patients were included in this prospective designed study, with a follow-up of at least 2 years. All patients suffered from a massive spasticity after traumatic spinal cord lesion. Conservative treatment options did not show satisfying results. All patients were injected a maximal dose of 2,000 units of botulinum toxin A in no more than keletal muscle groups. Clinical control examinations were performed after 2 weeks and after at least 2 years. Results: 6 patients reported a good or very good result. One patient offered increasing difficulty in walking for a short time after injection. 2 patients showed no beneficial effects. One patient experienced a modest temporary general weakness for 3 days. After 2 years, 3 patients showed improved function with persistent reduction of spasticity. In the other cases, the beneficial effect lasted for an average of 9 months. Conclusion: Botulinum toxin A injection seems to be an effective complementary therapy option in the treatment of spasticity of paraplegic patients with complete deficit of their motor function (ASIA A and B) and a spastic distribution pattern, effecting only a limited number of muscle groups. Caution has to be recommended for incomplete paretic patients, who are able to walk.