Study finds Botox can ease movement after stroke
BOSTON (AP) — Botox, the wrinkle-smoothing botulism toxin that has become the biggest sensation in cosmetic medicine, also can help stroke victims regain use of their clenched and rigid hands.
The findings, published in today's New England Journal of Medicine, add to the evidence that the food-poisoning toxin — in diluted form — can relax muscles contracted by a broad range of conditions, from writer's cramp to cerebral palsy.
Until now, though, most studies were unable to show much of an effect on routine function of limbs in stroke patients.
"I would anticipate that this study will actually expand the use, because this is the first study to show improved activities of daily living," said Dr. Allison Brashear, a neurologist at the University of Indiana who led the study.
One patient, a woman in her 20s, had suffered a stroke after giving birth. With one hand permanently clenched, she was reduced to changing diapers with the help of her teeth. After the toxin injections directly into the hand, she was able to handle diapers again.
About 4 million Americans have survived strokes, which cut off blood flow and injure the brain. Many patients' hands and fingers become clenched and rigid, often just on one side of their bodies, from overactive muscles.
Botox — a weakened form of the toxin produced by the potentially deadly food-poisoning germ — blocks a key chemical to paralyze the overactive muscles.
Botox was approved in April for cosmetic purposes to smooth wrinkles on the face.
The stroke researchers gave injections to 126 patients at 19 medical centers around the country. Some got Botox, the toxin made by Allergan of Irvine, Calif., which sponsored the experiment. Some patients were given sham injections for purposes of comparison.
At six weeks, 83 percent of the Botox group showed significant improvement in areas such as pain and their ability to dress themselves, wash their hands and hold their hands normally, compared with 53 percent in the other group. Sixty-two percent of the Botox group made significant improvement in the living skill each patient most wanted to improve.
The effects of each treatment typically lasted three to four months. No major side effects were reported.
Many insurance companies cover the injections. A single treatment, which can involve multiple shots, can cost $1,000 to $2,000.
Botulism toxin researcher Dr. Bipin Bhakta of the University of Leeds in England cautioned that stroke patients also suffer from weakness, not just clenched muscles, and Botox "shouldn't be seen as a treatment you give by itself."
Stroke patients also receive physical therapy and wear splints.