Centrally mediated late motor recovery after botulinum toxin injection: Case reports and a review of current evidence
Objective: Botulinum neurotoxin is commonly utilized in neurorehabilitation as a treatment for focal spasticity. Clinical experience has yielded observations of late motor recovery after intramuscular injection of botulinum neurotoxin, that are not readily explained by the classical mechanism of act...
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| Format: | Article |
| Language: | English |
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Medical Journals Sweden
2017-07-01
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| Series: | Journal of Rehabilitation Medicine |
| Subjects: | |
| Online Access: |
https://www.medicaljournals.se/jrm/content/html/10.2340/16501977-2257
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| _version_ | 1819002407201275904 |
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| author | Manuel F. Mas Sheng Li Gerard E. Francisco |
| author_facet | Manuel F. Mas Sheng Li Gerard E. Francisco |
| author_sort | Manuel F. Mas |
| collection | DOAJ |
| description | Objective: Botulinum neurotoxin is commonly utilized in neurorehabilitation as a treatment for focal spasticity. Clinical experience has yielded observations of late motor recovery after intramuscular injection of botulinum neurotoxin, that are not readily explained by the classical mechanism of action of the neurotoxin in controlling spasticity. These findings have triggered speculation regarding a botulinum neurotoxin mediated effect at the central level after peripheral intervention.
Methods: A review of current literature reveals evidence of distant action after peripheral botulinum neurotoxin injection in affected muscles, be it in other muscles, nerves, spinal cord or the cortex.
Results: Plausible explanations for a centrally mediated late motor recovery after botulinum neurotoxin injection include: (i) direct action of botulinum neurotoxin at distant sites in the central nervous system, mediated by retrograde transport of the neurotoxin into the spinal cord, and (ii) cortical reorganization due to botulinum neurotoxin-induced decrease in peripheral sensory input at the local injection site.
Conclusion: Additional research is required to further elucidate these hypotheses, as well as providing specific dosing specifications, patient selection criteria and the interplay with other therapeutic modalities necessary to promote late motor recovery. |
| first_indexed | 2024-12-20T23:04:37Z |
| format | Article |
| id | doaj.art-80817e064dae43698b7b62a2ee757c53 |
| institution | Directory Open Access Journal |
| issn | 1650-1977 1651-2081 |
| language | English |
| last_indexed | 2024-12-20T23:04:37Z |
| publishDate | 2017-07-01 |
| publisher | Medical Journals Sweden |
| record_format | Article |
| series | Journal of Rehabilitation Medicine |
| spelling | doaj.art-80817e064dae43698b7b62a2ee757c532022-12-21T19:23:53ZengMedical Journals SwedenJournal of Rehabilitation Medicine1650-19771651-20812017-07-0149860961910.2340/16501977-22572338Centrally mediated late motor recovery after botulinum toxin injection: Case reports and a review of current evidenceManuel F. Mas0Sheng LiGerard 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. manuel.mas@uth.tmc.edu. Objective: Botulinum neurotoxin is commonly utilized in neurorehabilitation as a treatment for focal spasticity. Clinical experience has yielded observations of late motor recovery after intramuscular injection of botulinum neurotoxin, that are not readily explained by the classical mechanism of action of the neurotoxin in controlling spasticity. These findings have triggered speculation regarding a botulinum neurotoxin mediated effect at the central level after peripheral intervention. Methods: A review of current literature reveals evidence of distant action after peripheral botulinum neurotoxin injection in affected muscles, be it in other muscles, nerves, spinal cord or the cortex. Results: Plausible explanations for a centrally mediated late motor recovery after botulinum neurotoxin injection include: (i) direct action of botulinum neurotoxin at distant sites in the central nervous system, mediated by retrograde transport of the neurotoxin into the spinal cord, and (ii) cortical reorganization due to botulinum neurotoxin-induced decrease in peripheral sensory input at the local injection site. Conclusion: Additional research is required to further elucidate these hypotheses, as well as providing specific dosing specifications, patient selection criteria and the interplay with other therapeutic modalities necessary to promote late motor recovery. https://www.medicaljournals.se/jrm/content/html/10.2340/16501977-2257 botulinumtoxinplasticitymotorrecovery |
| spellingShingle | Manuel F. Mas Sheng Li Gerard E. Francisco Centrally mediated late motor recovery after botulinum toxin injection: Case reports and a review of current evidence Journal of Rehabilitation Medicine botulinumtoxin plasticity motorrecovery |
| title | Centrally mediated late motor recovery after botulinum toxin injection: Case reports and a review of current evidence |
| title_full | Centrally mediated late motor recovery after botulinum toxin injection: Case reports and a review of current evidence |
| title_fullStr | Centrally mediated late motor recovery after botulinum toxin injection: Case reports and a review of current evidence |
| title_full_unstemmed | Centrally mediated late motor recovery after botulinum toxin injection: Case reports and a review of current evidence |
| title_short | Centrally mediated late motor recovery after botulinum toxin injection: Case reports and a review of current evidence |
| title_sort | centrally mediated late motor recovery after botulinum toxin injection case reports and a review of current evidence |
| topic | botulinumtoxin plasticity motorrecovery |
| url |
https://www.medicaljournals.se/jrm/content/html/10.2340/16501977-2257
|
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