Search

Botulinum toxin type A (BoNT/A) provides a valuable tool in the multi-modal treatment of spasticity. Incobotulinumtoxin A (InBoNT/A) is a highly purified BoNT/A agent, free of any complexing clostridial proteins.Clinical experience suggests that InBoNT/A is identical from efficacy, duration of therapeutic effect and tolerability profile. Our aim was to compare the effect of the CBoNT/A vs InBoNT/A on spasticity of the upper limb, evaluated with Modificated Aswhort Scale (MAS), and on amplitude of compound motor action potentials (CMAP) of biceps muscle in patients after brain stroke. A randomized, double-blind, parallel-group pilot single-centre study. Clinical and neurophysiological evaluation were performed at enrollment (T0), to 24 h (T1),one (T2) and three (T3) months from toxin injection. We recruited 9 subject. Both BoNTA reduced MAS scores but with no statistically significant difference. At T1 patients treated with IBoNT/A showed a greater reduction in CMAP compared with those treated with CBoNT/A. This difference is reduced at T2 but is again evident at T3. These data seem to indicate a tendency of IBoNT/A to present a more precocious and a longer duration effect respect to CBoNT/A. The low power of the statistical analysis, however, suggests to recruit a larger sample of patients.

About 50% of post-stroke patients remain aphasic a condition that greatly impede their reintegration to society. Results of Repetitive Transcranial Magnetic Stimulation (rTMS) as supplementary treatment for sub-acute post-stroke aphasia are controversial. We assessed the efficacy of inhibitory rTMS with conventional speech therapy to help recovery language performance in sub-acute stroke aphasia.In a randomised case-control double-blind study 12 non-fluent aphasic were consecutively enrolled. All patients suffered a first-ever stroke in the sub-acute stage defined as time since lesion onset from 1 month post-stroke. Patients were randomized either to receive real (low frequency on right-hemisphere homologue of Broca’s area) or sham rTMS, to a 3-week (5 day in a week). Immediately after each rTMS all patients received speech therapy. The speech performance was evaluated with Italian version of Aachener Aphasia Test (AAT), before (T0) and after (T1) treatments.Seven patients were treated with real rTMS and 5 patients with sham rTMS. Total and sub totals AAT scores showed a similar improvement in real and in sham rTMS groups between T0 and T1.In early phase of rehabilitation (

The purpose of this study was to assess the beneficial effect of BTX- A in the treatment of hemiplegic shoulder pain in chronic phase. 31 consecutive hemiplegic patients with different degree of hypertonus (groups 1 and 2) of the muscles of the painful shoulder, referred to 5 Rehabilitation Centers and underwent to neuromuscular blockade with pure BTX-A (150 Kd). The rating scales were: the FAT, the MAS, the pROM, the MRC and the VAS at rest and during nursing. Evaluations were performed at enrollment (T0), after 1 month (T1) and after 3 months post-treatment with BTX (T3). At T1 It has been observed a statistically significant reduction in VAS at rest and during nursing ( p p = 0.04) and passive ROM ( p