Stroke Recovery and Botox Therapy

By Michael Roberts

There are a couple of reasons why Botox therapy is likely to be a confusing topic for most people. It was for me the first time that I heard about it. It has proven to be a useful adjunct to other stroke rehabilitation methods though.

My own stroke left me with severe contracture of the flexor muscles on my left side. The therapists working with me thought I was making good progress but my extensor muscles always having to work against my flexors hampered this. My left foot would sickle inward and I couldn’t place it flat on the floor to bear my weight while walking. This condition resolved itself somewhat after much hard work.

My arm was even worse. The OT couldn’t get it to loosen up enough to work with me in recovering functionality. On one occasion, we even tried packing my arm in ice all the way up to my shoulder. It was painful but brought no relief from the spasticity. One of the physiatrists thought I was an ideal candidate for Botox treatment. He explained what that was.

It involved injections of botulism toxin. I wondered how that worked and if it was dangerous. I had heard that Botulism was a deadly poison. Catching a whiff of the scent of bitter almonds from the cup, I gasped, “Cyanide”! The doctor explained that the way Botulism killed was through a progressive weakening of the muscles of the body.

In its therapeutic application, the toxin is selectively injected into spastic muscles to make it possible to work their opposite muscle through a range of motion. For example, in order to release the triceps (the large muscle on the bottom of the upper arm) an injection would be made into its opposite muscle, the biceps that is the peaked muscle on the top of the upper arm, the one you show people when they say “Make a muscle”.

The toxin interferes with the transmission of impulses from one neuron to another effectively paralyzing the muscle and ending its interference with its opposite number. I wondered if there were any adverse side effects and how long the treatment lasted. The treatment wears off after 3 to 6 months. No problems have been reported.

Botox is also used in cosmetic procedures to reduce the appearance of wrinkles. I asked around to find out what else I could about Botox. As it turned out one of my sisters’ husbands had been treated with Botox to relieve a facial tic. It worked exactly as planned and he had no problems from the treatment.

My own experience was the same. The injections were painful but nothing that required anesthetics. Since the treatments began I have been able to pull my fingers out straight so that I can place my hand flat on the kitchen table.

Following is a list of internet resources on Botox Therapy (go to a search engine and type in “botox stroke” and read on!):

http://www.neurologychannel.com/botulinum/index.shtml

http://www.cnn.com/2002/HEALTH/conditions/08/07/botox.stroke.ap/index.html

http://www.medicine.indiana.edu/news_releases/archive_02/botox.html

http://www.wfubmc.edu/ortho/pub/botox.shtml

http://www.stroke.org/pages/recov_spastic.cfm?category=all

Copyright © September 2002

The Stroke Network, Inc.

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