Botulinum toxin therapy in neurology

Method and drug overview

The method is based on the local administration of medications containing botulinum toxin to relax overactive muscles.

• Main active substance: BoNT injections (botulinum toxin type A-hemagglutinin complex).
• Main objective: targeted reduction of pathological muscle tone.
• Target population: adult patients presenting with focal lower limb muscle spasticity.

Prescription criteria and rating scales

The prescription of botulinum toxin therapy requires strict adherence to clinical criteria and patient assessment:

1. Tone assessment: spasticity severity must be ≥ 2 points on the modified Ashworth scale.
2. General status: during the outpatient rehabilitation phase, the patient must be independent in basic activities of daily living—self-care, mobility, and communication (use of assistive devices is permitted).
3. Comprehensive approach: the procedure is integrated into the general program for restoring motor function and balance.

Role in the rehabilitation process

The use of botulinum toxin therapy is seamlessly integrated into the phased medical care system:

• Outpatient phase (Phase 3): performed in a day hospital or polyclinic setting, provided the patient has sufficient independence.
• Continuity of care: telemedicine technologies are actively utilized to bridge the inpatient and outpatient phases, which is especially valuable for residents of remote areas.
• Combined modalities: pharmacological muscle relaxation is supplemented with physical therapy, massage, local cryotherapy, and nutritional support.

Class and exam questions

What else to study on this topic

• Perinatal CNS lesions in children and classification of their syndromes
• Normal milestones of psychomotor development
• Management of patients with cerebral palsy
• Local cryotherapy and massage in spinal cord injury
• Nutritional support in the recovery period

Prepared by WhiteCoat Pro faculty in accordance with the medical school curriculum. For educational purposes only.