Effectiveness of botulinum toxin A in the treatment of spasticity of the lower extremities in adults - preliminary report.

BACKGROUND Botulinum toxin (BTX is currently a recognised treatment for local spasticity, especially in children with cerebral palsy. The following paper presents the early result of BTX treatment for adult patients with spastic paresis of the lower limbs. MATERIAL AND METHODS Twenty adult paraplegic patients (mean age 42 years) following cervical or thoracic SCI or suffering from MS, with moderate-to-severe spasticity in the lower extremities received BTX for the first time in life into the thigh adductor, knee flexor and foot flexor muscle groups. Results were evaluated using Modified Ashworth's Scale, Visual (Analogue) Scale for Pain Assessment, Modified Rivermead Mobility Index and Repty Functional Index prior to and three weeks after the administration of the toxin. RESULTS Improvement was observed in most patients, usually manifesting as reductions or resolution of pain. Mild side effects (low-grade fever and flu-like symptoms) occurred in only one patient. CONCLUSIONS Our study confirmed the efficacy and safety of BTX for focal lower limb spasticity in adults.