Abstract:
Botulinum toxin is used to treat hypertonia following TBI. Both cost and limits on the total number of units that may be used in a given treatment period, may make it difficult to treat all of the involved areas that are clinically indicated. The current injection technique involves injecting the toxin into quadrants of the involved muscle. This study explores whether injection guided by electromyographic search for a muscle's motor points might provide greater benefit from a smaller dose, thus allowing more comprehensive treatment from a given dose. Patients with TBI and hypertonia producing elbow flexion are randomized to receive a fixed dose of botulinum toxin into the biceps and/or brachioradialis by either the traditional technique or the motor point technique. Change in Ashworth score and Tardieu angle are the outcome measures being compared.