Hi Cyn,

botox info....not related to TOS but info none the less

1: Disabil Rehabil. 2007 Dec 15;29(23):1806-12.
Serial injection of botulinum toxin for muscle imbalance due to regional spasticity in the upper limb.

Turner-Stokes L, Ashford S.
Regional Rehabilitation Unit, Northwick Park Hospital, Middlesex, UK. lynne.turner-stokes@dial.pipex.com
BACKGROUND AND PURPOSE: Three-dimensional movement in the upper limb presents a challenge for functional management of regional spasticity. Potential toxicity of botulinum toxin limits the number of muscles which may be injected in any one session. Serial injection may offer a solution, but carries theoretical risk of development of resistance due to antibody formation. This article reviews a small case series, gathered in a post-acute neuro-rehabilitation setting, to evaluate the use of serial botulinum toxin injection in terms of goal achievement and clinical evidence for toxicity or resistance. METHODS: Nine patients with regional spasticity following acute stroke or brain injury had serial injection of botulinum toxin to muscle groups around the shoulder, elbow and/or wrist. Injection was followed by splinting/physiotherapy as appropriate. Goal attainment scaling was used to assess outcome. RESULTS: Functional goals achieved were reduction of pain (n=6/7) associated reaction (n=4/5) or care needs (n=5/6), improved gait (n=2/3) or independence in self-care (n=2/5). Two 'golden responder' cases are presented in detail to demonstrate resolution of symptoms with up to four serial injections of botulinum toxin over a period of up to 6 months. No clinical evidence of toxicity or resistance was seen in any case. CONCLUSION: These preliminary findings suggest that serial botulinum toxin injection followed by appropriate physiotherapy/splinting may provide effective treatment for regional spasticity. Resistance has not presented a problem in this post-acute situation, where treatment has not been required beyond a few months. Ongoing evaluation is underway.


1: J Forensic Sci. 2005 Jan;50(1):169-72.Links
Fatal case of BOTOX-related anaphylaxis?

Li M, Goldberger BA, Hopkins C.
Department of Pathology, Immunology and Laboratory Medicine, University of Florida College of Medicine, Gainesville, FL 32610-0275, USA.
Anaphylactic drug reactions are rare and often serious events. The Botulinum toxin A, marketed as BOTOX, was recently approved by the Food and Drug Administration for cervical dystonia and glabellar wrinkles, after its approved use and success with blepharospasm, strabismus, and disorders of the 7th cranial nerve. It has been well received due to its efficacy in improving facial lines. This case report documents the first death associated with a Botox-lidocaine mixture given to a woman for chronic neck and back pain. Based on the medical records, autopsy, and laboratory findings, the cause of death was determined to be anaphylaxis to the Botox-lidocaine mixture. The history, indications, off-label uses and possible future applications of Botox are reviewed as well as the uses and complications of lidocaine. Although the anaphylaxis cannot be definitively proven to be due to Botox alone, this case warns of an adverse reaction related to Botox, a drug that is rapidly expanding in range of use as well as increased usage.

love and hugs,

vic

Hey guys,
I am alive and wanting to get moving and can't due to the damn pain of entertaining someone who does not get pain at all!!!!

I am watching the leaves fall from the trees and the rain fall and wishing I had thicker skin to keep me warm! Not looking forward to cold days soon enough we'll have snow......is forcast for snow rain mix on next weekend!!!! eeekkk too cold for me is below 74 ahhhhhhhhhhhhhhhhhh!!

love and hugs to all who are around!!
Victoria