Objective: To investigate the benefits of the focal use of botulinum toxin in spasticity in the forearm seen after incomplete spinal cord injury.
Design: A single case study with standardized assessment before and at three-week intervals after injection.
Intervention: EMG-guided selective injection of botulinum toxin.
Subject: A 23-year-old man, 18 months post injury.
Measures: Rivermead Motor Assessment; grip strength; Jebsen hand tests; visual analogue scale; Ashworth spasticity scale.
Results: Weakness was seen as expected with some functional losses, but the patient made gains in the areas of concern: shaking hands, typing, using the hand to drink. These gains were sustained at 12 weeks.
Conclusion: Selective use of botulinum toxin to weaken muscles can lead to functional benefit.