OnabotulinumtoxinA muscle injection patterns in adult spasticity: a systematic literature reviewReport as inadecuate




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BMC Neurology

, 13:118

Movement disorders

Abstract

BackgroundOnabotulinumtoxinA has demonstrated significant benefit in adult focal spasticity. This study reviews the injection patterns i.e., muscle distribution, dosing of onabotulinumtoxinA for treatment of adult spasticity, as reported in published studies.

MethodsA systematic review of clinical trials and observational studies published between 1990 and 2011 reporting data on muscles injected with onabotulinumtoxinA in adult patients treated for any cause of spasticity.

Results28 randomized, 5 nonrandomized, and 37 single-arm studies evaluating 2,163 adult patients were included. The most frequently injected upper-limb muscles were flexor carpi radialis 64.0% of patients, flexor carpi ulnaris 59.1%, flexor digitorum superficialis 57.2%, flexor digitorum profundus 52.5%, and biceps brachii 38.8%. The most frequently injected lower-limb muscles were the gastrocnemius 66.1% of patients, soleus 54.7%, and tibialis posterior 50.5%. The overall dose range reported was 5–200 U for upper-limb muscles and 10–400 U for lower-limb muscles.

ConclusionsThe reviewed evidence indicates that the muscles most frequently injected with onabotulinumtoxinA in adults with spasticity were the wrist, elbow, and finger flexors and the ankle plantar flexors. OnabotulinumtoxinA was injected over a broad range of doses per muscle among the studies included in this review, but individual practitioners should be mindful of local regulatory approvals and regulations.

KeywordsBotulinum toxin OnabotulinumtoxinA Spasticity Muscles Injection patterns AbbreviationsBoNTBotulinum neurotoxin.

Electronic supplementary materialThe online version of this article doi:10.1186-1471-2377-13-118 contains supplementary material, which is available to authorized users.

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Author: Luba Nalysnyk - Spyridon Papapetropoulos - Philip Rotella - Jason C Simeone - Katharine E Alter - Alberto Esquenazi

Source: https://link.springer.com/







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