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Botox Eases Stroke Disability

Injections Lessen Muscle Stiffness, Improve Quality of Life

WebMD Health News
Reviewed by Gary D. Vogin, MD

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Aug. 7, 2002 -- Botox has become famous for its wrinkle-erasing properties, but researchers say the injections may also help stroke sufferers regain control of their daily lives.

Each year, nearly 750,000 Americans suffer from a stroke. Of the roughly two-thirds who survive, about half of them will become disabled. But a new study shows injections of Botox - which is a purified form of the bacterial poison that causes botulism -- in the wrist and finger can reduce muscle stiffness and disability in this area.

Stiff, rigid muscles in the hands and wrists are common among stroke survivors and a major cause of disability. The inability to use these muscles properly makes performing even the most basic tasks such as dressing and washing difficult or impossible.

Previous research has suggested that injecting Botox into the affected muscles might reduce pain and stiffness, but until now no large-scale scientific studies have backed up that idea.

In this study, researchers examined the effects of a one-time Botox injection in the wrist and finger muscles in a group of 126 stroke patients. Researchers measured the effectiveness of the injection in terms of improvements in the level of disability reported by the participants in four different areas: personal hygiene, dressing, pain, and limb position.

The study found that patients who received Botox continued to show greater improvements in both muscle stiffness and level of disability for up to 12 weeks following the injections compared to those who received a placebo. For example, nearly two-thirds of those who were treated with Botox had improvement in their most troublesome area of disability at six weeks compared to only about a fifth of the placebo group.

Study author Allison Brashear, MD, of the Indiana University School of Medicine, and colleagues say problems with stiff muscles in the wrists and fingers are particularly troublesome among stroke patients. And their findings suggest that Botox injections are a safe and effective way to temporarily improve the quality of life after a stroke.

Their report appears in the Aug. 8 issue of the New England Journal of Medicine.

In a commentary that accompanies the study, Lewis P. Rowland, MD, of Columbia-Presbyterian Medical Center in New York City, say these findings merit further study.

Rowland says there is some debate over whether muscle rigidity is the major cause of disability after stroke, which would limit the use of Botox as a potential treatment. But he says Botox injections have already been used to successfully treat a variety of muscle-related disorders, such as cerebral palsy, spinal cord injuries, and multiple sclerosis, in the last decade.

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