Botulinum toxin type A (incobotulinotoxin A) use in a patient with post-stroke upper limb spasticity: clinical case report

Spasticity syndrome is registered in 19-38% of patients after stroke. Botulinum toxin type a is a priority method of post-stroke spasticity therapy to expand the rehabilitation potential. The article illustrates a clinical observation of therapeutic effect of injections incubatoarele and with post-stroke spasticity of the upper limbs. The position of the hands with spasticity corresponded to figure III (H.Hefter). The key muscles for injection were determined by testing active and passive movements performed at different speeds and in different positions of the arm and its parts for each muscle pattern, which led to the diagnosis of spasticity in the chest, biceps, shoulder, shoulder muscles, circular pronator, superficial and deep finger flexors. Injection accuracy and functional muscle activity were monitored by ultrasound and needle electromyography. Prior to therapy and to monitor its effectiveness, motor functions of the upper limb were evaluated on the following scales: Fugl-Meyer, ARAT, Barthel Index, Ashworth scale, Rankine scale, British muscle strength assessment scale with positive results.

spasticity, incobotulotoxin A, rehabilitation, stroke, motor unit