Posted on 03/24/2009 9:06:00 PM PDT by neverdem
After her stroke, Francine V. Corso, a software engineer who worked on NASA’s lunar lander, was housebound from 1992 to 2001.
Her left arm was twisted up near her neck, making it difficult to pull on a blouse, and her fingers curled so rigidly that her nails buried themselves in her palm. When she finally learned to rise from her wheelchair, her contorted left leg had the so-called horse gait of many brain-injury victims — she stepped toe-downward, and then fought to keep her foot from rolling over.
Now, with injections of botulinum toxin every three months, she says, “I’m completely transformed — I drive, I volunteer, I take art classes.” Her fingers are so relaxed that a manicurist can lacquer her nails red.
Botulinum toxin, the wrinkle smoother best known by the brand name Botox, has many medical uses, some official and some off label. It helps dystonia victims regain control of spasming muscles, actors who struggle with flop sweat slow down the flow, and children with clubfoot avoid surgery.
Its use in stroke victims is still off label — that is, it is not approved for that purpose by the Food and Drug Administration. But it is so widely accepted that Medicare and other insurers will usually reimburse for its use.
Nonetheless, said Dr. David M. Simpson, a professor of neurology at Mount Sinai Medical Center in New York and a leading botulinum researcher, only about 5 percent of the stroke patients who could benefit from its use ever get it.
Primary care doctors who oversee nursing homes often do not know about it, he said. Relatively few doctors are trained to do the injections, which go much deeper than dermatologists do to erase frown lines. And most neurologists are in the habit of prescribing antispasticity drugs like...
(Excerpt) Read more at nytimes.com ...
This is good but in some cases, regular massage will work wonders in contracted hands and feet.
This is Excellent and Breakthru Knowledge for So Many Patients. Hopefully, it will be shouted from the rooftops.
>This is good but in some cases, regular massage will work wonders in contracted hands and feet.
True, and then there’s the electrical stimulation that might get those muscles to relax as well. It would probably be [more] effective to use all these methods plus physical therapy for the first couple of months after the stroke.
That is make the muscle-use as easy as possible, correcting as well as possible any constant nural feedback (muscle-tightening), and helping the brain to re-learn (w/ the physical therapy).
At least that’s my opinion... I’m not actually a doctor, though biology is pretty interesting.
The irony is that a significant number of people have been temporarily or permanently paralyzed by botox injections. Go figure.
I saw something on this on one of those extreme medical diagnosis shows (can’t remember the name). A guy developed severe muscular torticollis (I think) twisting his head over to the left side so badly that he couldn’t lift it off his shoulder. He lost his job, his fiancee, and just about everything else when a specialist finally managed to alleviate the condition with botox injections. It’s not a cure, but it keeps him functional and lets him live a normal life.
Study: Lots of red meat increases mortality risk
Oozing Through Texas Soil, a Team of Amoebas Billions Strong
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A friend of mine has also had the botox treatments for her migraines (also great success). No insurance coverage at all, but her quality of life has so improved that she says (jokingly) she’d do anything for her botox. If you didn’t know about the headaches, you would just think she was doing it for the smooth forehead. She gets her shots at a local dermatologist’s office (referred by the family doctor.)
Thanks for posting this.
We will be getting this info to a dear friend, who had a terrible stroke years ago post cardio surgery.
She is basically paralyzed on her left side and it gets worse each day. She is now very prone to falls and can only get around in her wheel chair.
Do you have the links to how to inject the botox? If so please Freepmail me with them.
You're welcome. IIRC, I've read about it at least once before.
Do you have the links to how to inject the botox? If so please Freepmail me with them.
"Just before the first needle sank in, she let visitors know how she felt about which she calls 'the stim.'"
"'This,' announced Ms. Corso, who is almost 5 feet tall, 'is what separates the men from the boys.'"
"The syringe was wired to an electric stimulator that pulsed a charge — up to a tenth of an amp — twice a second. When Dr. Simpson believed he had pierced the right muscle, he dialed it up. If the correct finger began twitching in sync, he knew he was there, and pressed the plunger. If not, he moved the needle and tried again."
A neurologist who is competent with electromyography has to be found. In the procedure, the muscles that lost their nerves in the stroke are located by electromyography. Those muscles are in a permanent state of contraction until an injection of botulinum toxin paralyzes those muscles.
Here's a search strategy for literature at PubMed:
(botulinum toxin or botox or Myobloc or Xeomin) and (stroke or cva or cerebrovascular accident)
Copy that and paste in PubMed's query box. I'd start with the 42 review articles.
Thanks for the suggestion and here is the resulting search links:
By the way our two friends who are breast cancer survivors still thank you for the links you provided a few years ago.
Thanks
Dave
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