For doctors - therapy goal planning
Which patient is suitable for treatment with botulinum toxin A?
The treatment of patients with relatively well preserved motor function and/or complex spastic patterns requires profound functional, topographical and anatomical knowledge.
Ultrasound is used as an injection control so that small muscles can also be treated.
A prerequisite for being able to treat patients with spasticity after a stroke is optimal and clear patient selection: Does the patient have a classic flexion pattern?
It is important to carry out a diagnosis, an assessment of the spasticity and a therapy goal planning.
Achieving therapy goals in the long term.
Characteristics of meaningful therapy goals.
Good therapy goals should also meet several criteria. They should:
- be concrete
- be verifiable
- be achievable
- be meaningful in terms of reducing symptoms
- be within one's own sphere of influence
- include intermediate steps if necessary
- be formulated positively
Guidelines
"For focal spasticity, focal drug injection treatment with botulinum toxin A usually has (BoNT A) has a better benefit-risk ratio (see below) and should be used before the use of oral antispasticity medications when feasible (strong consensus)." (See source guidelines p. 8)
Source:
AWMF online: Guidelines for diagnosis and therapy in neurology. Therapy of spastic syndrome. German Society of Neurology, p. 8.
Long version: https://www.awmf.org/uploads/tx_szleitlinien/030-078l_S2k_Therapie_spastisches_Syndrom_2019-06-verlaengert.pdf
Note: For reasons of better legibility, the masculine form is used for personal designations. Corresponding terms generally apply to all genders in terms of equal treatment. The shortened form of language is for editorial reasons only and does not include any rating.