Harvard Health Letter

By the way, doctor: Could Botox help my father, who has had a stroke?

Q. My father had a massive stroke that left him paralyzed on one side. He's aware of all that's going on and can talk some, but he has severe spasticity in his left elbow, shoulder, and hand, along with muscle atrophy. Would Botox injections help the painful spasms in his arm and hand?

A. Botox is a drug derived from botulinum toxin. At high doses, it paralyzes muscles. At lower ones, it relaxes them. It's well-known as a wrinkle reducer. But Botox was originally approved as a treatment for uncontrollable blinking (blepharospasm) and misaligned eyes (strabismus), and it's used for a number of neurological conditions that feature overactive muscles.

Severe damage to one side of the brain, whether from a stroke, trauma, or some other cause, leads to not only weakness on the opposite side of the body but also abnormal muscle "tone" (spasticity is a type of abnormal muscle tone). Frequently people hold a leg out stiffly, while holding an arm close to the chest with the elbow, wrist, and fingers flexed. Daily activities become difficult. Just keeping the arm and hand clean is a problem. Often there's a lot of pain.

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