Botox not just for glamour, great for stroke victims too

Nov 1 2005

Botox, or botulinum toxin's, main claim to fame currently seems to be associated with stars and others who wish for fuller lips and ironed out wrinkles, but the treatment does in fact have a far more credible and worthwhile reputation which continues to grow.

New research has shown that repeated treatments of botulinum toxin type A (BoNTA) over one year after a stroke can improve muscle tone and reduce pain in the arms and hands, making it easier for patients to dress themselves and perform personal hygiene.

Often spoken of as a poison, the toxin relieves muscle spasms and pain in stroke victims and has also been seen to ease the pain for sufferers of chronic low back pain.

Other research has shown that the toxin, can be an effective headache pain reliever.

This new study is the first long-term study to evaluate repeated treatment with BoNTA for post-stroke spasticity, a muscle tightness that inhibits movement.

According to Allison Brashear, M.D., professor and chairman of neurology at Wake Forest University Baptist Medical Center, the treatment resulted in sustained and meaningful functional improvement that made a difference in the daily lives of stroke patients and the people who care for them.

The study involved 35 centers and included 279 stroke patients with wrist, hand or elbow spasticity.

During the year-long study, all study participants received up to five treatments with BoNTA, which is sold under the trade name BOTOX.

For the study, the injections were given at the wrist, thumbs, fingers and elbows to block overactive nerve impulses that trigger excessive muscle contractions.

The researchers found that by week six muscle tone in the wrist, fingers, thumb, and elbow was markedly improved from baseline, and was sustained throughout the study.

The study also measured functional disability in four areas: hygiene, dressing, limb posture and pain.

Before the first treatment, patients selected an area that was most important to them, and on a four-point scale that ranged from "no disability" to "severe disability," at least 50 percent of patients achieved a 1-point or greater improvement in the area they targeted.

The study found that adverse events related to treatment, such as headache, pain in the arm, or an influenza-like illness, were reported in 7 percent of patients.

Brashear said these results show that the treatment is safe and well-tolerated in post-stroke patients and may represent a significant advantage over many oral anti-spasticity medications often associated with a high incidence of side effects which can seriously hinder rehabilitation.

Every year, about 700,000 Americans suffer a new or recurring stroke.

Stroke is a leading cause of serious, long-term disability in the United States, and it is estimated that the costs associated with lost productivity due to stroke-related disability will total $21.8 billion in 2005.

The research was funded by Allergan Inc., the pharmaceutical company that developed BoNTA.

The study is published in the October issue of Stroke.