SPASTICITY-BOTULINUM TOXIN ISSUES

SUMMARY

1. Drug interactions: gentamicin may potentate the paralytic effect.

2. Cannot be used with pregnancy & lactation.

3. Neutralising antibodies develop with higher doses & more frequent injections.

4. Why it may not work: wrong muscle, insufficient dose, fibrotic muscle, contractures, too far from motor point.

5. Recommended dose: 400 units, however 500-600 units can be used. Higher risk of systemic botulism (flu-like symptoms, generalised muscle weakness, atonic bladder).

6. Wait 3 months between injections to avoid systemic botulism or formation of neutralising antibodies.

Reference(s)

Cifu, D.X. (2020). Braddom’s physical medicine and rehabilitation. Elsevier. Get it on Amazon.
Cuccurullo, S. (2019). Physical medicine and rehabilitation board review. New York: Demosmedical. Get it on Amazon.
O’Young, B., Young, M.A. and Stiens, S.A. (2008). Physical Medicine and Rehabilitation Secrets. Mosby. Get it on Amazon.