Automatic EMG-guided botulinum toxin treatment of spasticity

Conventional electromyographic (EMG) guidance in botulinum toxin therapy can localize a muscle, but the amount of electrical activity is assessed only subjectively. We wanted to introduce a quantitative EMG criterion, according to which the decision for/against toxin application could be made. Turn/...

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Veröffentlicht in:Clinical neuropharmacology 1997-06, Vol.20 (3), p.195-203
Hauptverfasser: FINSTERER, J, FUCHS, I, MAMOLI, B
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container_title Clinical neuropharmacology
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creator FINSTERER, J
FUCHS, I
MAMOLI, B
description Conventional electromyographic (EMG) guidance in botulinum toxin therapy can localize a muscle, but the amount of electrical activity is assessed only subjectively. We wanted to introduce a quantitative EMG criterion, according to which the decision for/against toxin application could be made. Turn/amplitude analysis (TAA) was applied to nine patients with severe paraspasticity (n = 5), right upper or lower limb spasticity (n = 3), or tetraspasticity (n = 1) before and after toxin administration. Muscles were selected for toxin application if both mean turns/second and mean amplitude/turn exceeded the level of 150. A mean Dysport dose of 116 mouse units (mu) (range 40-240 mu) was administered to each of the 26 muscles that met the EMG criterion. Thirty days after the injection, activities of daily living, pain, and TAA count improved in 89%, tone in 78%, and range of motion in 56% of the patients by at least 1 point on corresponding 5-point rating scales. TAA provides a useful EMG criterion for/against botulinum toxin application. Muscle selection according to this criterion leads to a significant subjective and objective toxin effect. TAA is a valuable tool to determine the benefit of single and subsequent botulinum toxin injections in the treatment of spasticity.
doi_str_mv 10.1097/00002826-199706000-00002
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We wanted to introduce a quantitative EMG criterion, according to which the decision for/against toxin application could be made. Turn/amplitude analysis (TAA) was applied to nine patients with severe paraspasticity (n = 5), right upper or lower limb spasticity (n = 3), or tetraspasticity (n = 1) before and after toxin administration. Muscles were selected for toxin application if both mean turns/second and mean amplitude/turn exceeded the level of 150. A mean Dysport dose of 116 mouse units (mu) (range 40-240 mu) was administered to each of the 26 muscles that met the EMG criterion. Thirty days after the injection, activities of daily living, pain, and TAA count improved in 89%, tone in 78%, and range of motion in 56% of the patients by at least 1 point on corresponding 5-point rating scales. TAA provides a useful EMG criterion for/against botulinum toxin application. Muscle selection according to this criterion leads to a significant subjective and objective toxin effect. TAA is a valuable tool to determine the benefit of single and subsequent botulinum toxin injections in the treatment of spasticity.</description><subject>Adult</subject><subject>Aged</subject><subject>Anti-Dyskinesia Agents - administration &amp; dosage</subject><subject>Anti-Dyskinesia Agents - therapeutic use</subject><subject>Biological and medical sciences</subject><subject>Botulinum Toxins - administration &amp; dosage</subject><subject>Botulinum Toxins - therapeutic use</subject><subject>Electromyography</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Muscle</subject><subject>Muscle Spasticity - drug therapy</subject><subject>Muscle Spasticity - physiopathology</subject><subject>Pain</subject><subject>Pharmacology. 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Drug treatments</topic><topic>Range of Motion, Articular</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>FINSTERER, J</creatorcontrib><creatorcontrib>FUCHS, I</creatorcontrib><creatorcontrib>MAMOLI, B</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><jtitle>Clinical neuropharmacology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>FINSTERER, J</au><au>FUCHS, I</au><au>MAMOLI, B</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Automatic EMG-guided botulinum toxin treatment of spasticity</atitle><jtitle>Clinical neuropharmacology</jtitle><addtitle>Clin Neuropharmacol</addtitle><date>1997-06-01</date><risdate>1997</risdate><volume>20</volume><issue>3</issue><spage>195</spage><epage>203</epage><pages>195-203</pages><issn>0362-5664</issn><eissn>1537-162X</eissn><coden>CLNEDB</coden><abstract>Conventional electromyographic (EMG) guidance in botulinum toxin therapy can localize a muscle, but the amount of electrical activity is assessed only subjectively. We wanted to introduce a quantitative EMG criterion, according to which the decision for/against toxin application could be made. Turn/amplitude analysis (TAA) was applied to nine patients with severe paraspasticity (n = 5), right upper or lower limb spasticity (n = 3), or tetraspasticity (n = 1) before and after toxin administration. Muscles were selected for toxin application if both mean turns/second and mean amplitude/turn exceeded the level of 150. A mean Dysport dose of 116 mouse units (mu) (range 40-240 mu) was administered to each of the 26 muscles that met the EMG criterion. Thirty days after the injection, activities of daily living, pain, and TAA count improved in 89%, tone in 78%, and range of motion in 56% of the patients by at least 1 point on corresponding 5-point rating scales. TAA provides a useful EMG criterion for/against botulinum toxin application. Muscle selection according to this criterion leads to a significant subjective and objective toxin effect. TAA is a valuable tool to determine the benefit of single and subsequent botulinum toxin injections in the treatment of spasticity.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott</pub><pmid>9197941</pmid><doi>10.1097/00002826-199706000-00002</doi><tpages>9</tpages></addata></record>
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source MEDLINE; Journals@Ovid Complete
subjects Adult
Aged
Anti-Dyskinesia Agents - administration & dosage
Anti-Dyskinesia Agents - therapeutic use
Biological and medical sciences
Botulinum Toxins - administration & dosage
Botulinum Toxins - therapeutic use
Electromyography
Female
Humans
Male
Medical sciences
Middle Aged
Muscle
Muscle Spasticity - drug therapy
Muscle Spasticity - physiopathology
Pain
Pharmacology. Drug treatments
Range of Motion, Articular
title Automatic EMG-guided botulinum toxin treatment of spasticity
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