Botox Helps Stroke Patients

Injections improved muscle control and eased limb pain, study found

FRIDAY, Oct. 28, 2005 (HealthDay News) -- Perhaps best known for its wrinkle-banishing ability, Botox can also help stroke patients with uncontrolled limb movements recover some functioning, according to a new study.

Repeated injections of Botox, or botulinum toxin type A, helped stroke survivors regain enough function to perform everyday activities such as dressing themselves without pain, said Dr. Allison Brashear, a professor and chairman of neurology at Wake Forest University Baptist Medical Center, Winston-Salem, N.C.

"It's evident that Botox makes a difference in function," she said.

Brashear presented the findings Friday at the American Association of Physical Medicine and Rehabilitation annual meeting, in Philadelphia. The study was funded by Allergan Inc., the company that developed Botox.

Botox has been used "off-label" for the past five years or so for stroke patients, according to Brashear. Off-label use refers to the common practice of prescribing a drug or treatment for a purpose not specifically approved by the U.S. Food and Drug Administration.

"The issue that this study is trying to address is to get a handle on the functional outcome of that therapy," she said.

Botulinum toxin type A, a protein complex produced by the bacterium Clostridium botulinum, contains the same toxin that causes food poisoning. But sterile, purified botulin toxin in small doses also blocks the release of acetylcholine, a chemical released by nerve cells that signals muscles to contract.

"We all agree that Botox relaxes muscles," Brashear said. "What this paper tried to get a handle on is what does that mean to the [stroke] patient."

Brashear's team injected the wrists, fingers and elbow flexors of 279 patients with post-stroke muscle spasticity. Treatments were spaced at least 12 weeks apart during the year-long study.

The team measured muscle tone and disability in four areas, including hygiene, dressing, limb posture and pain, and asked the patients which area was most important to them in which to improve. No one had serious side effects, and muscle tone greatly improved by week six, she found.

The improvement persisted throughout the year-long study. The team used a four-point scale for the four areas ranging from "no disability" to "severe disability," and at the end of the study, at least half the survivors achieved a one-point or more improvement in the area they deemed most important.

Botox was first approved in 1998 to treat eye problems such as "lazy eye." Next, it got approval from the FDA for the treatment of a movement disorder that causes neck and shoulder contractions. Then it was OK'd for frown lines.

Other studies have found the treatment effective for a variety of other conditions, including sweaty palms and feet.

Another expert said the new study of stroke survivors confirms what some clinicians have long known.

"I've been using it for years for patients with spasticity," said Dr. Todd Schlifstein, a physical medicine and rehabilitation physician at the New York University Medical Center, New York.

"Botox paralyzes the muscle, making it more relaxed, and you can control exactly how much and where you give it," he said.

The new study, he said, is "additional proof of the benefit of Botox for reducing spasticity in stroke patients."

Roughly one-third of stroke survivors experience spasticity, Brashear estimates. That's no small number -- according to the American Stroke Association, 700,000 people in the United States suffer a stroke each year, and about 4 million are stroke survivors.

Schlifstein estimates that up to 10 percent of stroke survivors could benefit from Botox injections.

Typically, a stroke survivor who experiences spasticity is referred to a neurologist or a physical medicine rehabilitation specialist, Brashear said. They can assess whether the condition warrants treatment with Botox.

More information

To learn more about Botox, visit the U.S. Food and Drug Administration.

Related Stories

No stories found.
logo
www.healthday.com