Abstract | BACKGROUND: METHODS: We retrospectively examined the medical records of patients who received local BoNT ( onabotulinumtoxin A) injections into the flexor hallucis longus (FHL) and flexor digitorum longus (FDL) muscles. All patients suffered stroke-related leg paralysis and spasticity. RESULTS: The study participants were 58 patients (mean age, 61.4 ± 10.3 years, ± SD) with time since stroke of 6.7 ± 4.4 years. The stroke type was cerebral hemorrhage (n = 38) and cerebral infarction (n = 20). After a total of 124 BoNT administrations with medical records entries on the subjective symptoms, the odds for symptomatic improvement was approximately 5.8 times higher in patients of the infarction group compared with the hemorrhage group (OR = 5.787, 95% CI = 2.369-14.134, p = 0. 000). Fifty-one patients (32 with cerebral hemorrhage, 19 with cerebral infarction) received the first local BoNT injection and had available medical records, analysis of which showed a significantly higher rate of symptomatic improvement in patients of the infarction group than those of the hemorrhage group (p = 0.006). After adjustment by factors known to influence treatment outcome (degree of spasticity and paralysis, BoNT dosage, and extent of FDL muscle control of toe movements), the treatment effect was predominantly higher in patients with cerebral infarction. CONCLUSION:
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Authors | Toru Takekawa, Takatoshi Hara, Naoki Yamada, Tomoharu Sato, Yuki Hasegawa, Satoshi Takagi, Kazushige Kobayashi, Tomohide Kitajima, Masahiro Abo |
Journal | Clinical neurology and neurosurgery
(Clin Neurol Neurosurg)
Vol. 226
Pg. 107620
(03 2023)
ISSN: 1872-6968 [Electronic] Netherlands |
PMID | 36805253
(Publication Type: Journal Article)
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Copyright | Copyright © 2023 Elsevier B.V. All rights reserved. |
Chemical References |
- Botulinum Toxins, Type A
- Neuromuscular Agents
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Topics |
- Humans
- Middle Aged
- Aged
- Hammer Toe Syndrome
(complications)
- Retrospective Studies
- Botulinum Toxins, Type A
- Stroke
(complications)
- Muscle Spasticity
- Paralysis
- Cerebral Hemorrhage
(complications)
- Treatment Outcome
- Cerebral Infarction
(complications)
- Infarction
(complications)
- Neuromuscular Agents
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