ReviewClinical drug investigation2018
Safety Profile of High-Dose Botulinum Toxin Type A in Post-Stroke Spasticity Treatment.
Review in Clinical drug investigation, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
29 citing papers in PubMed, 4 syntheses or guidelines pooled it, 49 citations in OpenAlex.
- Botulinum Toxin for Pain Relief in Cancer Patients: A Systematic Review of Randomized Controlled Trials.Toxins · 2024Pooled it
- Effectiveness of Botulinum Toxin on Hand Tremor Intensity and Upper Limb Function in Patients with Parkinson's Disease: Results of a Systematic Review.Tremor and other hyperkinetic movements (New York, N.Y.) · 2023Pooled it
- Pooled it
- Pooled it
- Research progress in the use of botulinum toxin type a for post-stroke spasticity rehabilitation: a narrative review.Annals of medicine · 2025Review
- Patient-Centred and Daily Life-Oriented Botulinum Toxin Treatment for Stroke Survivors with Upper Extremity Spasticity-Effects and Practical Aspects.Journal of clinical medicine · 2025Article
- Impact of Adequate Disinfection Techniques for Ultrasound-Guided Injections in Musculoskeletal Rehabilitation: A Scoping Review.Diagnostics (Basel, Switzerland) · 2025Review
- Role of the ICF Generic-30 Set in a multidimensional rehabilitation plan for improving functioning in a patient with surgical outcomes of removal of oligodendroglioma: a case report.BMC musculoskeletal disorders · 2025Article
- Review
- Article
- Article
- Aesthetic Rehabilitation Medicine: Enhancing Wellbeing beyond Functional Recovery.Medicina (Kaunas, Lithuania) · 2024Review
- Stroke rehabilitation: from diagnosis to therapy.Frontiers in neurology · 2024Review
- Botulinum Toxin-A High-Dosage Effect on Functional Outcome and Spasticity-Related Pain in Subjects with Stroke.Toxins · 2023Review
- A Comprehensive Review of Physical Therapy Interventions for Stroke Rehabilitation: Impairment-Based Approaches and Functional Goals.Brain sciences · 2023Review
- Article
- Botulinum toxin use in patients with post-stroke spasticity: a nationwide retrospective study from France.Frontiers in neurology · 2023Article
- Sensorimotor Rhythm-Based Brain-Computer Interfaces for Motor Tasks Used in Hand Upper Extremity Rehabilitation after Stroke: A Systematic Review.Brain sciences · 2022Review
- Pain Management and Rehabilitation for Central Sensitization in Temporomandibular Disorders: A Comprehensive Review.International journal of molecular sciences · 2022Review
- Intramuscular tetanus neurotoxin reverses muscle atrophy: a randomized controlled trial in dogs with spinal cord injury.Journal of cachexia, sarcopenia and muscle · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Botulinum toxin type A (BoNT-A) is considered the gold standard for the treatment of focal post-stroke spasticity (PSS). However, a recently published study estimated that a significant percentage of patients affected by PSS could benefit from higher doses of BoNT-A than those permitted by current directives in the countries studied. Several studies have reported the use of high doses of BoNT-A in the management of patients affected by severe PSS; however, the most important adverse effect of this drug might be systemic diffusion of the toxin, which could potentially be related to its dose. Even if systemic toxicity is a rare event, fear of systemic toxicity is still the most relevant concern regarding use of high doses. The aim of our narrative review was to show the state of the art on the use of high doses of BoNT-A in patients affected by PSS in order to define the safety profile, focusing on both clinical and instrumental assessment of systemic effects. Current evidence from the literature suggests that higher doses of BoNT-A are effective in reducing spasticity of upper and lower limbs after stroke, with rare occurrence of mild adverse effects. The use of high doses seems to be an effective and safe therapeutic option to reduce multifocal or generalized PSS in selected patients. In particular, the potential role of higher doses in order to improve the functional outcome of these patients should be noted.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.