Neurological Disorders

Botulinum Toxin as a Stand-Alone Treatment for Muscle Spasticity: Review of the Evidence

Abstract

Abdel Magid O Bakheit

Botulinum toxin has been shown to reduce muscle tone and improve motor function in children and adults with muscle spasticity. However, it is not clear whether the magnitude and/ or the duration of the beneficial effect of this treatment are increased by combining it with other spasticity treatments. Nonetheless, some guidelines on the management of spasticity recommend that botulinum toxin is not used unless it is combined with other spasticity treatment modalities, such as physiotherapy. In this article it is argued that the clinical evidence that supports such recommendations is at best weak and that the recommendations are probably too restrictive. It is further suggested that the use of botulinum toxin as a stand-alone treatment of spasticity is justifiable, especially when other therapies are not immediately available for use in combination with the toxin.