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World J Neurol. Dec 28, 2013; 3(4): 133-137
Published online Dec 28, 2013. doi: 10.5316/wjn.v3.i4.133
Overview of botulinum toxin as a treatment for spasticity in stroke patients
Hirotaka Isoyama, Naoyuki Takeuchi
Hirotaka Isoyama, Department of Physical Medicine and Rehabilitation, Hospital of Hokkaido University, Hokkaido 060-8648, Japan
Naoyuki Takeuchi, Department of Physical Medicine and Rehabilitation, Tohoku University Graduate School of Medicine, Sendai 980-8576, Japan
Author contributions: Both authors contributed to the manuscript.
Correspondence to: Hirotaka Isoyama, MD, Department of Physical Medicine and Rehabilitation, Hospital of Hokkaido University, Kita14 Nishi5 Kita-ku, Sapporo, Hokkaido 060-8648, Japan. isoyama@huhp.hokudai.ac.jp
Telephone: +81-11-7066066 Fax: +81-11-7066067
Received: June 26, 2013
Revised: October 3, 2013
Accepted: November 2, 2013
Published online: December 28, 2013
Processing time: 203 Days and 21.9 Hours
Abstract

Spasticity after the occurrence of stroke induces limb deformity, functional disability and/or pain in patients, which limits their activities of daily living and deteriorates their quality of life. Botulinum toxin (BTX) has recently been reported as an efficacious therapeutic agent for the treatment of spasticity. Systematic review and meta-analysis studies have demonstrated that BTX therapy after stroke reduces spasticity and increases physical activity capacity and performance levels. Moreover, BTX can be used as an adjuvant in physiotherapy. Several studies have confirmed that the combination of BTX therapy and physiotherapy improves motor recovery. However, to date, only a few such combination studies have been conducted and their findings are considered preliminary and controversial. Therefore, future studies are required to determine the appropriate combination of treatment methods that will aid motor recovery.

Keywords: Botulinum toxin; Rehabilitation; Stroke; Spasticity; Neurorehabilitation

Core tip: In this overview, we describe that botulinum toxins (BTXs) were very useful to reduce spasticity in stroke patients. Moreover, we introduce studies on appropriate effective and safe injection methods; pilot studies that evaluated combined rehabilitation and BTX treatment; and adverse events after BTX injection, including risk factors of neutralizing antibodies.