Using Botox to Treat Spasticity After Stroke

Allison Brashear, MD, chair of Neurology at the Medical Center, reported that a multicenter study found repeated treatments of botulinum toxin (Botox) over one year was well tolerated by the human body and resulted in a significant decrease in spasticity (excessive muscle tightness), pain frequency and average pain intensity in the upper limbs after a stroke.

The study would lead, three years later, to the Food and Drug Administration approving Botox to treat upper limb spasticity after a stroke. For Brashear, the study in 2007 and FDA approval in 2010 capped years of research into botulinum toxin.

For example, an initial study she published in 2002 in the New England Journal of Medicine had reported that one-time injections of Botox were safe and effective in people with wrist and finger spasticity after a stroke. Follow-up research in 2004 demonstrated repeated benefits of the injections in patients with post-stroke spasticity.

Brashear is chair of the American Academy of Neurology Spasticity/Dystonia Advisory Board. She directs courses at national workshops that teach the technique of botulinum toxin treatment.

She also heads the spasticity clinic at Wake Forest Baptist.