Affiliation(s)
1. Departement of Neurology, Lebanese Hospital university hospital Geitawi, 1100 Achrahieh Beirut, Lebanon
2. Holy Spirit University, Faculty of Medical Sciences, 446 Jounieh, Mount Lebanon, Lebanon
3. Lebanese University, Faculty of Medical Sciences, 1003 HadathBaabda, Mount Lebanon, Lebanon
ABSTRACT
Botulinum toxin found its way into a lot of medical treatments improving
the quality of life in many clinical situations. When treating spasticity, this toxin is
injected in the affected muscle to decrease its tension and hyperactivity. The
isolation of the affected muscles for injection is done either by anatomical
palpation of the muscle which is also known as non-guided injection technique,
or by using the ultrasound or the electromyography also known guided injection
technique. In this study which is a prospective observational study that
included patients over a 6 months period, 28 patients aged between 2 and 78
years, with spasticity naïve to botulinum toxin injections or had already been
injected more than 3 months ago,were injected using guided injection technique. The optimal doses of
botulinum toxin were administered based on the age, the severity of the
condition, and affected muscle groups. In pediatric population these were also
calculated according to the body weight. All patients were evaluated pre and 4
weeks post injection using the MAS Score (Modified Ashworth Scale). Statistical
analysis showed a very significant response to treatment as compared to the pre-injection
condition, for upper limbs, lower limbs, and all muscle groups with almost
absent significant local or systemic side effects (with a p value less than 0.001). Conclusion: guided techniques for botulinum
toxin injections showed a great efficacy in the treatment of spasticity along
with no regional or systemic side effects and are relatively well tolerated by
patients. This finding leads to a better management of spasticity and to a
decrease in oral medication intake and secondarily a decrease in their possible
side effects.
KEYWORDS
Botulinum toxin, spasticity, EMG, ultrasound.
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