Spasticity and Botulinum Toxin

What is spasticity?

Spasticity is an increase in the stiffness of muscle movement, and it arises as part of the upper motor neurone syndrome. This is a collection of symptoms and signs that are seen when some part of the nervous pathways that control and coordinate voluntary movement is disrupted. 

Spasticity is commonly seen in patients with many neurological conditions such as:

  • Cerebral palsy
  • Stroke
  • Head injury
  • Multiple sclerosis

How can OCE help?

Management of spasticity is effective when spasticity is relatively mild or short-lived. However a significant proportion of people with spasticity – perhaps well over half – have problems that benefit from being seen by specialists in neurological rehabilitation who can:

  • Accurately identify any treatable factors that are causing or exacerbating the problem
  • Consider whether all physical treatments available have been used
  • Review the appropriateness of past and current medications
  • Undertake more specialist management.

We provide a number of specialist managements through our Neurological Rehabilitation Service, including:

  • Seating and postural management
  • Casting, splints and stretching programmes
  • Expert advice on medication strategies
  • Botulinum toxin injections
  • Expert multi-professional assessment to consider
    • Operations on tendons and joints
    • Insertion of an intra-thecal baclofen pump
    • Other rare treatment

Complex Spasticity Clinics

These clinics are run weekly by Professor Udo Kischka with a therapist and often another doctor.

The clinic specifically assesses people for botulinum toxin, and gives it, but also considers and gives or recommends other alternative and additional treatments as needed. Not all patients receive botulinum toxin injections.

Joint Specialist Spasticity Clinics

These clinics are run monthly with the Neurosurgical Department (John Radcliffe Hospital, Oxford) and the Musculoskeletal Department (Nuffield Orthopaedic Centre) and therapists.

The primary goal is to assess people for the insertion of intra-thecal baclofen pumps, but other treatments such as orthopaedic surgery and nerve injections are considered.