Regaining movement – Botox treatment

Botox treatment after stroke – not for beauty

Botox treatment may be familiar from the news and the beauty industry, but it has been used in healthcare just as much, and even longer, in both cases. Doctors use the same property of Botox in both cases: the compound inhibits nerve-muscle communication and thus helps muscles relax.

In the beauty industry, it relaxes the muscles responsible for wrinkles, and in healthcare, it relaxes spastic, stiff muscles that occur after nervous system injuries and strokes. Although botox treatment alone, without development, does not eliminate the problem, in many cases this little bit may be missing to get the recovery going in the right direction.

Overstretched muscles

One possible consequence of nervous system injury and stroke is that the muscles become stiff, spastic, and stuck in constant contraction.

Excessive tension in specific muscle groups inhibits or restricts the movements necessary for everyday life. It makes daily activities such as eating and drinking, dressing, washing, personal hygiene, and the ability to change positions a challenge: whether it is from bed to chair, or from chair to semi-standing, walking, or climbing stairs.

To facilitate movements, it is necessary to relax the muscles, one possible way of which is botox treatment.

How does botox work?

Spasticity and muscle stiffness occur after injury or stroke because muscles become stuck in a contracted state and pairs of muscles contract in opposite directions. While spasticity may appear to be a muscle disorder, the real cause is a disruption in the way muscles and nerves communicate.

When a stroke affects the motor cortex and its connections, the nervous system often becomes unable to transmit commands to the muscles, stop contraction commands, which keeps the muscle in a constant state of tension, or coordinate the contraction of individual muscle bundles.

Botox (botulinum toxin A) is a nerve blocker. Nerve cells are connected to muscles through their long extensions (axons). When the extensions reach the muscles, they become terminal bundles and wrap around part of the muscle. The nerve communicates with the muscle using so-called neurotransmitters. These are chemical compounds that are released by the nerve at the nerve-muscle junction and taken up by the muscle, causing the muscle to contract.

If these transmitters are constantly being released, the muscle remains contracted – and then relaxes when the nerve no longer sends signals.

Botox works at this connection: it prevents signals from the nerve from reaching the muscle, and since no signal to contract is received, the muscle relaxes.

Effect of treatment

Studies and experience show that injecting Botox into the muscle – in strictly controlled amounts – can significantly reduce spasticity and improve arm movements. However, Botox treatment alone is only a temporary solution; the effect does not last longer than 3-6 months. Without another injection, the stiffness returns.

The most important effect of Botox treatment is to reduce muscle stiffness and spasticity for a limited time, while physiotherapy and training can improve the real causes behind the spasms, the neuromuscular communication problems.

Long-term improvement can only be achieved if Botox treatment is combined with intensive training and development.

Hungarian example

Károly is a stroke survivor. He had a stroke on his left side a few years ago: his walking and upper limb movement are quite impaired compared to his right side. After a few ARNI treatments, his upper limb movement improved somewhat, his muscles relaxed, but it is still not the same movement as before the stroke.

During one of my university consultations, I heard something interesting about Botox treatment, and I got a contact for a neurologist in Pécs who performs Botox treatments on stroke patients. I mentioned the Botox treatment to Károly, who called the doctor, and Károly was lucky enough to get an appointment at short notice.

Dr. Károlyon presented the Botox treatment process and its benefits to Károly at a conference. We are currently waiting for the effects to relax the muscles and make it easier for Károly to perform the movements necessary for everyday life – both in the upper and lower limbs – whether it is walking, eating, dressing, or perhaps working or engaging in physical activity.

István Kusztor,