Article

Objective: To determine the effect of botulinum toxin A on spasticity and
somatosensory evoked potentials of hand muscles in patients who have undergone
cerebrovascular accident. Design: Preliminary, prospective, before-after study design. Patients: Six subjects prospectively followed after application of
botulinum toxin A in the rehabilitation department of a university hospital.
Methods: All patients underwent botulinum toxin A injection to the upper
extremity muscles in varying combinations and carried out a home-based exercise
programme. Primary outcome measure was median somatosensory evoked potential of
hand muscles (N20). Secondary outcome measures were: spasticity assessed
clinically by Modified Ashworth Scales (MAS); functional ability analysis
assessed by Physician's Rating Scale (PRS); and functional difficulties reported
by patients or their care-givers by patient disability and care-giver burden
rating scale (PD & CBRS). Results: MAS, PRS and PD & CBRS improved with botulinum
toxin A treatment. In the affected limb, N20 potentials were impaired compared
with those in the unaffected side. With botulinum toxin A treatment, although
improvement in overall N20-P25 amplitudes was significant, as a result of limited
sample size, post hoc pair-wise comparisons with Bonferroni correction failed to
yield any significant pairs. Conclusion: The improvement in the median
somatosensory evoked potentials following botulinum toxin A treatment suggests
that central somatosensory patterns in hemiplegia can be modified by peripheral
inputs

Langue : ANGLAIS