Botulinum toxin in gait dysfunction due to ankle clonus: A case series

Abstract

OBJECTIVES: Our purpose is to assess the effectiveness of Botulinum toxin (Btx) on gait dysfunction due to ankle clonus in neurological patients. METHODS:We use a retrospective case note review of 11 patients attending the Regional Acquired Brain Injury Unit (RABIU), Musgrave Park Hospital, Belfast, Northern Ireland. All patients had received Btx for the treatment of ankle clonus. Demographic data including diagnosis and time since neurological insult was collected. Information regarding walking speed and assistance required to walk before and after Btx treatment was analysed. RESULTS: In 10 of 11 patients, walking speed was significantly improved at 4-6 weeks post Btx injections (P = 0.006) and at 14-16 weeks post Btx injections (P = 0.005). Eight patients reduced their level of dependency on assistance. Subjective improvements in levels of pain, gait pattern and 'toe clawing' were also reported. CONCLUSIONS: Our findings suggest that Botulinum toxin has a role in treating ankle clonus in neurological patients, where it interferes in gait. Walking speed and level of dependence on others improved in this group.

Managing Upper Extremity Clonus With Intramuscular Botulinum Toxin–A Injections in a Patient Poststroke

“…We did not assess the long‐term effects of BoNTA on clonus, and it remains to be seen how long the benefit of BoNTA injections on clonus can be maintained. Moreover, we did not record the clonus duration using standardized tests [5].…”

“…Spasticity management with BoNTA has been demonstrated as an important treatment modality to reduce muscle tone and to improve quality of life poststroke [3,4]. The use of BoNTA injections for management of clonus has also been reported to be an effective treatment strategy [3‐5]. Previous studies show the effectiveness of BoNTA injections for treatment of ankle clonus [5,6] or finger clonus in the upper extremity (UE) [7].…”

“…The use of BoNTA injections for management of clonus has also been reported to be an effective treatment strategy [3‐5]. Previous studies show the effectiveness of BoNTA injections for treatment of ankle clonus [5,6] or finger clonus in the upper extremity (UE) [7]. Clonus is more readily observable in the ankle, but UE clonus is not as readily observed by clinicians [2.8].…”