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Chapter 18 - The Use of Botulinum Neurotoxin in Spasticity Using Ultrasound Guidance

Published online by Cambridge University Press:  02 November 2023

Daniel Truong
Affiliation:
University of California, Riverside
Dirk Dressler
Affiliation:
Hannover Medical School
Mark Hallett
Affiliation:
National Institutes of Health (NIH)
Christopher Zachary
Affiliation:
University of California, Irvine
Mayank Pathak
Affiliation:
Truong Neuroscience Institute
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Summary

Botulinum neurotoxin (BoNT) injection is an effective treatment of spasticity in upper and lower limbs. Accuracy of injection needle placement in target muscles is of great importance in maximizing effectiveness of the treatment, and avoiding both treatment failure and adverse events such as weakening of adjacent musculature. Various guidance techniques improve effectiveness and avoid side effects, including anatomical landmark location and palpation, electromyographic guidance, and ultrasound guidance. In recent years, the availability of portable ultrasound devices has facilitated the application of ultrasound guidance, which is quick, painless, and now readily available. This chapter uses photographs, anatomical illustrations, and ultrasound images to illustrate injection techniques for specific muscles involved in the common patterns of spastic posturing.

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Chapter
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Publisher: Cambridge University Press
Print publication year: 2023

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References

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