Abstract
We report the improvement of pain and activities of daily living in five patients who received botulinum toxin therapy with echo guidance for spasticity that developed as an aftereffect of cerebral infarction since November 2011. The medicine was injected into the pectoralis major, flexor digitorum superficialis, flexor digitorum profundus, flexor pollicis longus of the upper extremities, extensor halluces longus, and posterior tibial muscles, as well as the medial and lateral heads of the gastrocnemius muscle in the lower extremities. Use of echo guidance in botox therapy allows identification of the spastic muscle to be targeted and assessment of the direction and depth of injection. This method also allows identification of surrounding nerves and blood vessels, which permits an approach to the target muscle without damage to nerves and blood vessels.
