First experience with botulinum toxin type A in central prosoparesis


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Abstract

Background. Stroke leads to the development of a number of persistent neurological disorders; one of them is paresis of mimic muscles. Currently, there are no validated tools for assessing the severity of central prosoparesis and effective methods for restoring motor functions of the face from the standpoint of evidence-based medicine. Description of the clinical case. The presented clinical case describes the approaches to the diagnosis and correction of facial asymmetry in a stroke patient used by the authors. The complex of rehabilitation measures, in addition to specialized therapeutic exercises, included the introduction of botulinum toxin type A into the muscles of the intact half of the face in order to create optimal conditions for motor rehabilitation. In this article, an injection protocol indicating the target muscles and the doses of botulinum toxin used is provided. As a result of the study, the effectiveness of botulinum therapy in relation to the correction of facial asymmetry in central prosoparesis was demonstrated. Conclusion. A set of measures made it possible to achieve an improvement in symmetry at rest and an increase in the volume of active movements on the affected side of the face in patient K. The effectiveness of the use of Xeomin in the formation of favorable conditions for the uniform restoration of the motor functions of the facial muscles was demonstrated, while it was possible to avoid the formation of pathological motor phenomena. It is necessary to continue accumulating data in studies aimed at evaluation of the effectiveness of BT and developing a comprehensive rehabilitation program for central prosoparesis in order to improve the outcomes of patients’ rehabilitation.

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About the authors

A. A Rimkevichus

Scientific Center of Neurology

Moscow, Russia

R. Kh Lyukmanov

Scientific Center of Neurology

Moscow, Russia

E. V Shalimanova

Scientific Center of Neurology

Moscow, Russia

R. K Shikhkerimov

Scientific Center of Neurology

Moscow, Russia

E. V Gnedovskaya

Scientific Center of Neurology

Moscow, Russia

Natalya A. Suponeva

Scientific Center of Neurology

Email: nasu2709@mail.ru
Dr. Sci. (Med.), Corresponding Member of the Russian Academy of Sciences, Chief Researcher, Head of the Department of Neurorehabilitation and Physical Therapy Moscow, Russia

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