Summary
Ten patients with spastic drop foot were treated by local injections of botulinum toxin A (botulinum toxin A haemagglutinin complex). The purpose was to improve stance and gait and/or to facilitate physiotherapy and patient care. Various calf muscles were injected using EMG guidance. The average dose used was 23 ng. Prior to and 4 weeks after treatment, positions of the upper and lower ankle joint at rest and the corresponding end positions of passive and active movement were determined. In addition, changes of spasticity and pain, the transmission phenomenon and stance and gait were evaluated. Most patients showed improvement of some aspects of the spastic drop foot. Positions of the upper and lower ankle joint were improved in most of the patients, as were the other para meters examined. Except for weakness of the injected muscles no side-effects were observed. The results appear promising and may be optimized in further trials by using higher doses of the toxin.
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References
Ashworth B (1964) Preliminary trial of carisoprodol in multiple sclerosis. Practitioner 192:540–542
Brin MF, Fahn S, Moskowitz C, Friedmann A, Shale HM, Green PE, Blitzer A, List T, Lange D, Lovelace RE, McMahon D (1988) Localized injections of botulinum toxin for the treatment of focal dystonia and hemifacial spasm. Adv Neurol 50:599–608
Ceballos Baumann AO, Konstanzer A, Dengler R, Conrad B (1990) Lokale Injektionen von Botulinum-Toxin A bei zervikaler Dystonie: Verlaufsbeobachtungen an 45 Patienten. Aktuel Neurol 17:139–145
Cohen LG, Hallett M, Geller BD, Hochberg F (1989) Treatment of focal dystonias of the hand with botulinum toxin injections. J Neurol Neurosurg Psychiatry 52:355–363
Das TK, Park DM (1989) Botulinum toxin in treating spasticity. Br J Clin Pract 43:11
Dengler R, Konstanzer A, Ceballos-Baumann AO (1990) Lokale Therapie mit Botulinum Toxin A bei fokalen Dystonien. Aktuel Neurol 17:133–138
Deuschl G, Löhle E, Heinen F, Lucking C (1991) Ear click in palatal tremor: its origin and treatment with botulinum toxin. Neurology 41:1677–1679
Dressler D, Benecke R, Conrad B (1989) Botulinum Toxin in der Therapie kraniozervikaler Dystonien. Nervenarzt 60:386–393
Gasser R, Fritsch K, Arnold G, Oertel W (1991) Botulinum toxin A in orthopaedic surgery. Lancet 338:761
Greene P, Shale H, Fahn S, Brin M, Friedman A (1987) Treetment of torticollis with injection of botulinum toxin. Abstract. Neurology 37 [Suppl]:123
Jankovic J, Brin MF (1991) Therapeutic uses of Botulinus toxin. N Engl J Med 324:1186–1194
Jankovic J, Schwartz K (1991) Botulinum toxin treatment of tremors. Neurology 41:1185–1188
Paal G (1986) Orthopädische Probleme bei Erkrankungen und Schädigungen des ZNS. In: Jäger M, Wirth K (eds) Praxis der Orthopädie. Thieme, Stuttgart, pp 474–490
Rivest J, Lees AJ, Marsen CD (1991) Writer's cramp: treatment with botulinum toxin injections. Mov Disord 6:55–59
Snow BJ, Tsui JKC, Bhatt MH, Varela M, Hashimoto SA, Calne DB (1990) Treatment of spasticity with botulinum toxin: a double-blind study. Ann Neurol 28:512–515
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Dengler, R., Neyer, U., Wohlfarth, K. et al. Local botulinum toxin in the treatment of spastic drop foot. J Neurol 239, 375–378 (1992). https://doi.org/10.1007/BF00812153
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DOI: https://doi.org/10.1007/BF00812153