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Spasticity AND botulinum toxin

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https://www.readbyqxmd.com/read/28919499/ultrasound-guidance-for-phenol-neurolysis-to-the-musculocutaneous-nerve
#1
Mary E Matsumoto, Jessica Berry, Herbie Yung, Martha Matsumoto, Michael C Munin
OBJECTIVE: This study compared electrical stimulation only (e-stim) to ultrasound with e-stim (US) guidance in phenol neurolysis of the musculocutaneous nerve (MCN) for elbow flexor spasticity. We also evaluated the US appearance of MCN in this population. DESIGN: Retrospective review SETTING: University hospital outpatient clinic PARTICIPANTS: Adult patients (N=167) receiving phenol neurolysis of the MCN for treatment of elbow flexor spasticity between 1997 to 2014 and adult control subjects...
September 14, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/28919457/patterns-of-botulinum-toxin-treatment-for-spasticity-and-bleeding-complications-in-patients-with-thrombotic-risk
#2
Chetan P Phadke, Vivekanand Thanikachalam, Farooq Ismail, Chris Boulias
The purpose of this study was to assess the prevalence of compartment syndrome or major bleeding episodes and compare compartment syndrome, patient and intervention characteristics in 110 patients with stroke (treated with Warfarin, new oral anticoagulants, antiplatelet, or no anticoagulants) treated for spasticity in deep leg compartment muscles with botulinum toxin injections [onabotulinumtoxinA (n = 77); incobotulinumtoxinA (n = 33)]. We reviewed 674 injection cycles (range 1-25 cycles per patient) and found no cases of compartment syndrome in any patient groups...
September 15, 2017: Toxicon: Official Journal of the International Society on Toxinology
https://www.readbyqxmd.com/read/28879524/uptake-of-clostridial-neurotoxins-into-cells-and-dissemination
#3
Chloé Connan, Michel R Popoff
Clostridial neurotoxins, botulinum neurotoxins (BoNT) and tetanus neurotoxin (TeNT), are potent toxins, which are responsible for severe neurological diseases in man and animals. BoNTs induce a flaccid paralysis (botulism) by inhibiting acetylcholine release at the neuromuscular junctions, whereas TeNT causes a spastic paralysis (tetanus) by blocking the neurotransmitter release (glycine, GABA) in inhibitory interneurons within the central nervous system. Clostridial neurotoxins recognize specific receptor(s) on the target neuronal cells and enter via a receptor-mediated endocytosis...
September 7, 2017: Current Topics in Microbiology and Immunology
https://www.readbyqxmd.com/read/28877510/heart-rate-variability-modifications-induced-by-high-doses-of-incobotulinumtoxina-and-onabotulinumtoxina-in-hemiplegic-chronic-stroke-patients-a-single-blind-randomized-controlled-crossover-pilot-study
#4
Alessio Baricich, Elisa Grana, Stefano Carda, Andrea Santamato, Claudio Molinari, Carlo Cisari, Marco Invernizzi
BACKGROUND: Botulinum toxin type A is a valid and safe treatment for focal spasticity, with documented effects on both sympathetic and parasympathetic systems. Heart rate variability can provide detailed information about the control of the autonomic nervous system on cardiovascular activities. Previous studies in literature showed no significant changes in Heart Rate Variability with doses >600 U of incobotulinumtoxinA in chronic post stroke spastic patients; however, at present time, these results have not been confirmed with doses >600 U of onabotulinumtoxinA...
September 4, 2017: Toxicon: Official Journal of the International Society on Toxinology
https://www.readbyqxmd.com/read/28837075/botulinum-toxin-for-the-treatment-of-neuropathic-pain
#5
REVIEW
JungHyun Park, Hue Jung Park
Botulinum toxin (BoNT) has been used as a treatment for excessive muscle stiffness, spasticity, and dystonia. BoNT for approximately 40 years, and has recently been used to treat various types of neuropathic pain. The mechanism by which BoNT acts on neuropathic pain involves inhibiting the release of inflammatory mediators and peripheral neurotransmitters from sensory nerves. Recent journals have demonstrated that BoNT is effective for neuropathic pain, such as postherpetic neuralgia, trigeminal neuralgia, and peripheral neuralgia...
August 24, 2017: Toxins
https://www.readbyqxmd.com/read/28834868/outcomes-of-intrathecal-baclofen-therapy-in-patients-with-cerebral-palsy-and-acquired-brain-injury
#6
Young Kwon Yoon, Kil Chan Lee, Han Eol Cho, Minji Chae, Jin Woo Chang, Won Seok Chang, Sung-Rae Cho
Intrathecal baclofen (ITB) has been known to reduce spasticity which did not respond to oral medications and botulinum toxin treatment. However, few results have been reported comparing the effects of ITB therapy in patients with cerebral palsy (CP) and acquired brain injury. This study aimed to investigate beneficial and adverse effects of ITB bolus injection and pump therapy in patients with CP and to compare outcomes to patients with acquired brain injury such as traumatic brain injury and hypoxic brain injury...
August 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28825663/efficacy-of-repeated-botulinum-toxin-type-a-injections-for-spastic-equinus-in-children-with-cerebral-palsy-a-secondary-analysis-of-the-randomized-clinical-trial
#7
Bo Young Hong, Hyun Jung Chang, Sang-Jee Lee, Soyoung Lee, Joo Hyun Park, Jeong-Yi Kwon
Botulinum toxin A is considered an important tool to control spasticity in children with cerebral palsy. Several factors are known to affect the efficacy of botulinum toxin, such as dosage, appropriate muscle selection and application, age, and accompanying therapy. A multicenter, double-blind, randomized, prospective phase III clinical trial of botulinum toxin A for the treatment of dynamic equinus in 144 children with cerebral palsy was performed to compare the efficacies of letibotulinumtoxin A and onabotulinumtoxin A...
August 21, 2017: Toxins
https://www.readbyqxmd.com/read/28819801/botulinum-toxin-treatment-in-multiple-sclerosis-a-review
#8
REVIEW
Yasaman Safarpour, Tahereh Mousavi, Bahman Jabbari
Purpose of review The purpose of this review is to provide updated information on the role of botulinum neurotoxin (BoNT) therapy in multiple sclerosis (MS). This review aims to answer which symptoms of multiple sclerosis may be amenable to BoNT therapy. Recent findings We searched the literature on the efficacy of BoNTs for treatment of MS symptoms up to April 1st 2017 via the Yale University Library's search engine including but not limited to Pub Med and Ovis SP. The level of efficacy was defined according to the assessment's criteria set forth by the Subcommittee on Guideline Development of the American Academy of Neurology...
August 17, 2017: Current Treatment Options in Neurology
https://www.readbyqxmd.com/read/28818530/recent-developments-in-clinical-trials-of-botulinum-neurotoxins
#9
Antoniangela Cocco, Alberto Albanese
Botulinum neurotoxins (BoNTs) are increasingly used in clinical practice for several indications. Following the pioneering years of discoveries, the recent years have witnessed an increase of new indications and new toxin brands. We review here the clinical trials on BoNTs performed since 2014 and put them into perspective. We also review the ongoing trials listed by the National Institutes of Health registry (Clinicaltrials.gov). The following indications are reviewed here: blepharospasm, cervical dystonia, spasticity, cerebral palsy, urinary incontinence, headache, topical formulations, postoperative cardiac arrhythmia, keloids and scars...
August 14, 2017: Toxicon: Official Journal of the International Society on Toxinology
https://www.readbyqxmd.com/read/28806237/botulinum-toxin-use-in-rehabilitation-clinics-a-survey-to-highlight-differences-and-similarities
#10
Rajiv Singh
Spasticity is a complex condition and its management is multifaceted, involving physical therapies as well as interventions with botulinum toxin. There is currently no standard for best practice and also wide variation in spasticity service set-ups and the background of clinicians involved in treatment. This could potentially cause large differences in practice. The aim of this survey was to attempt to identify some of the common elements of service delivery as well as highlight any significant variations in service models...
August 11, 2017: International Journal of Rehabilitation Research. Revue Internationale de Recherches de Réadaptation
https://www.readbyqxmd.com/read/28805760/-mapping-of-motor-points-in-the-flexor-muscles-of-the-arm-for-the-optimization-of-botulinum-toxin-injections-in-treatment-of-spasticity
#11
A P Kovalenko, V K Misikov, K A Sinelnikov, A N Karimov
AIM: To study the location and verification of motor points (MP) of the upper limbs for targeting botulinum toxin (BT) type A injections in the treatment of spasticity. MATERIAL AND METHODS: Twenty healthy people were examined. Using electromyography a complete study of the muscles of the upper limbs was conducted. RESULTS: Anatomical localization of MP was performed. The location of MP is identical and does not depend on sex, age and the dominant limb...
2017: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
https://www.readbyqxmd.com/read/28792585/centrally-mediated-late-motor-recovery-after-botulinum-toxin-injection-case-reports-and-a-review-of-current-evidence
#12
Manuel F Mas, Sheng Li, Gerard E Francisco
OBJECTIVE: Botulinum neurotoxin is commonly utilized in neurorehabilitation as a treatment for focal spasticity. Clinical experience has yielded observations of late motor recovery after intramuscular injection of botulinum neurotoxin, that are not readily explained by the classical mechanism of action of the neurotoxin in controlling spasticity. These findings have triggered speculation regarding a botulinum neurotoxin mediated effect at the central level after peripheral intervention...
August 31, 2017: Journal of Rehabilitation Medicine
https://www.readbyqxmd.com/read/28766025/determinants-of-botulinum-toxin-discontinuation-in-multiple-sclerosis-a-retrospective-study
#13
Pamela Latino, Letizia Castelli, Luca Prosperini, Maria Rita Marchetti, Carlo Pozzilli, Morena Giovannelli
The purpose of the present study was to investigate the long-term persistence to treatment with botulinum toxin type A (BoNT-A) for multiple sclerosis (MS)-related spasticity and the determinants of BoNT-A discontinuation in daily clinical setting. We retrospectively collected data of patients who started BoNT-A injections and underwent regular follow-up visits. Determinants of BoNT-A discontinuation were explored in a time-to-event Cox regression analysis which included as independent variables a large set of demographic and clinical characteristics...
August 1, 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28741118/strategies-to-decrease-injection-site-pain-in-botulinum-toxin-therapy
#14
Lejla Paracka, Katja Kollewe, Florian Wegner, Dirk Dressler
Botulinum toxin is now used for numerous indications including dystonias, spasticity, cerebral palsy, hyperhidrosis, cosmetics and chronic migraine. It has to be injected into its target tissues thus causing injection site pain. We wanted to compare the efficacy of various analgesic interventions suggested for reduction of injection site pain. In 13 healthy controls, pain thresholds in the fingertips II and III bilaterally were determined by the Mechanical Pain Threshold Test and the Repetitive Pain Stimulation Test at baseline and under nitrous oxide/oxygen, ice spray, local anaesthetic cream and forearm ischaemia...
July 24, 2017: Journal of Neural Transmission
https://www.readbyqxmd.com/read/28735160/longitudinal-assessment-of-gait-quality-in-children-with-bilateral-cerebral-palsy-following-repeated-lower-limb-intramuscular-botulinum-toxin-a-injections
#15
Felicity A Read, Roslyn N Boyd, Lee A Barber
BACKGROUND: Serial lower limb intramuscular Botulinum toxin-A (BoNT-A) injections are administered to children with bilateral spastic cerebral palsy (BCP) to reduce spasticity, improve walking and functional mobility, and delay the need for orthopaedic surgery. Gait quality is clinically assessed following BoNT-A with 2D video gait assessments (2DVGA) using the Edinburgh Visual Gait Score (EVGS). AIM: To determine the effect of three consecutive treatment cycles of lower limb intramuscular BoNT-A injections on gait quality using the EVGS in children with BCP by retrospectively reviewing repeated 2DVGA measures...
July 20, 2017: Research in Developmental Disabilities
https://www.readbyqxmd.com/read/28726023/benefits-and-risks-of-non-approved-injection-regimens-for-botulinum-toxins-in-spasticity
#16
Andrea Santamato, Francesco Panza
Spasticity with muscle paresis and loss of dexterity is a common feature of upper motor neuron syndrome due to injuries or the pyramidal tract in several neurological conditions. Botulinum toxin type A has been considered the gold standard treatment for spasticity and movement disorders, with efficacy, reversibility, and low prevalence of complications. During the last 30 years, thousands of studies of its use have been performed, but few guidelines are available. Therefore, there is great variability in both the doses and intervals of administration and the approaches taken by clinicians with considerable experience in spasticity and movement disorder treatment...
July 19, 2017: Drugs
https://www.readbyqxmd.com/read/28724781/muscle-disuse-caused-by-botulinum-toxin-injection-leads-to-increased-central-gain-of-the-stretch-reflex-in-the-rat
#17
Jessica Pingel, Hans Hultborn, Lui Naslund-Koch, Dennis Bo Jensen, Jacob Wienecke, Jens Bo Nielsen
Botulinum toxin (Btx) is used in children with cerebral palsy and other neurological patients to diminish spasticity and reduce the risk of development of contractures. Here, we investigated changes in the central gain of the stretch reflex circuitry in response to botulinum toxin injection in the triceps surae muscle in rats. Experiments were performed in 21 rats. 8 rats were in a control group and 13 rats were injected with 6 IU of Btx in the left triceps surae muscle. Two weeks after Btx injection larger monosynaptic reflexes (MSR) were recorded from the left (injected) than the right (non-injected) L4 + L5 ventral roots following stimulation of the corresponding dorsal roots...
July 19, 2017: Journal of Neurophysiology
https://www.readbyqxmd.com/read/28716516/hypertonia
#18
Sarah Helen Evans, Mark William Cameron, Justin Michael Burton
Hypertonia is the abnormal increase in muscle tone as a result of upper motor neuron lesions. There are three following clinical types: spasticity, dystonia, and rigidity. Management of hypertonia is individualized and should be directed by the patient and/or family׳s goals of care as well as the underlying cause of the hypertonia. Treatment options include stretching, strengthening, positioning, oral medications, botulinum toxin injections, phenol injections, as well as surgical procedures. Without effective management, hypertonia can result in muscle imbalance, abnormal movement patterns, pain, joint contracture, joint deformity, and ultimately negatively impact a patient׳s function...
July 14, 2017: Current Problems in Pediatric and Adolescent Health Care
https://www.readbyqxmd.com/read/28676144/ixcellence-network%C3%A2-an-international-educational-network-to-improve-current-practice-in-the-management-of-cervical-dystonia-or-spastic-paresis-by-botulinum-toxin-injection
#19
Klemens Fheodoroff, Roongroj Bhidayasiri, Luis Jorge Jacinto, Tae Mo Chung, Kailash Bhatia, Therese Landreau, Carlo Colosimo
Botulinum toxin is a well-established treatment for a number of conditions involving muscle hyperactivity, such as focal dystonia and spastic paresis. However, current injection practice is not standardized and there is a clear need for structured training. An international group of experts in the management of patients with cervical dystonia (CD) and spastic paresis created a steering committee (SC). For each therapeutic area, the SC developed a core slide set on best practice, based on the literature. International sites of expertise were identified for training and courses were designed to include lectures and casebased learning...
April 2017: Functional Neurology
https://www.readbyqxmd.com/read/28676142/the-italian-real-life-post-stroke-spasticity-survey-unmet-needs-in-the-management-of-spasticity-with-botulinum-toxin-type-a
#20
A Picelli, A Baricich, C Cisari, Stefano Paolucci, Nicola Smania, Giorgio Sandrini
The present national survey seeking to identify unmet needs in the management of spasticity with botulinum toxin type A focused on the use of OnabotulinumoxinA, since this is the brand with the widest range of licensed indications in Italy. Physicians from twenty-four Italian neurorehabilitation units compiled a questionnaire about "real-life" post-stroke spasticity management. OnabotulinumtoxinA was reported to be used in the following average doses: upper limb 316.7 ± 79.1 units; lower limb 327.8 ± 152...
April 2017: Functional Neurology
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