Centrally mediated late motor recovery after botulinum toxin injection: Case reports and a review of current evidence
Manuel F. Mas, Sheng Li, Gerard E. Francisco
Department of Physical Medicine and Rehabilitation, University of Texas Health Science Center at Houston McGovern Medical School and TIRR Memorial Hermann, Houston, Texas, USA. E-mail: manuel.mas@uth.tmc.edu
DOI: 10.2340/16501977-2257
Lay Abstract
Spasticity, or muscle tightness, can occur after a stroke or brain injury. Injection of botulinum toxin to spastic muscles is a commonly utilized intervention for these findings. We have observed several cases with paralysis and tightness of the hand muscles, years after a stroke, that also recover movement in the injected muscles. This is not readily explained by the usual mechanisms of Botulinum toxin. There is ample evidence that Botulinum toxin may also work at other areas after injection, including the spinal cord and brain. Perhaps, this is how it can appear so long after initial paralysis. Thus, these potential actions should be further studied.
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