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Spasticity Management with Botulinum Toxin

Treatment of focal spasticity by ultrasound-guided BoNT injection into selected muscles.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Fizik Tedavi ve Rehabilitasyon department. Book Appointment →

What is Spasticity Management with Botulinum Toxin?

Botulinum toxin A blocks acetylcholine release at the presynaptic neuromuscular junction, producing temporary denervation in selected muscles and reducing spasticity. Effect begins within 3-7 days and lasts 3-4 months. Brands include Botox, Dysport and Xeomin.

Indications: spastic CP (gastrosoleus, adductor and hamstring to improve gait pattern), post-stroke upper extremity spasticity (biceps and flexor muscles), multiple sclerosis, spastic diplegia, focal dystonia and cervical dystonia.

The procedure should be performed with ultrasound, EMG or electrical stimulation guidance. The target muscle must be correctly localized and the maximum dose must not be exceeded (3-6 U/kg body weight in pediatric patients).

Symptoms

Focal spasticity
Disturbance of gait pattern
Upper extremity muscle hypertonia
Difficulty with hygienic care
Painful spasms
Orthotic intolerance

Risk Factors

Diffuse generalized spasticity (insufficient indication)
Pregnancy
Neuromuscular disease
Aminoglycoside use
Infection at injection site
Previous allergy

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • When focal spasticity limits function
  • When oral antispasticity drugs are insufficient
  • When contractures develop
  • When gait quality deteriorates
  • When care becomes difficult

Treatment Methods

01
Spasticity assessment (Ashworth)
02
Determining the target muscle
03
US/EMG-guided injection
04
Dose calculation (U/kg)
05
Post-injection stretching and exercise
06
Optimization of orthotic compatibility
07
Repeat every 4-6 months
08
Combination with physical therapy

Which Department to Visit?

You can visit our Fizik Tedavi ve Rehabilitasyon department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Fizik Tedavi ve Rehabilitasyon Department

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.