Botulinum Toxin for Post-Stroke Limb Spasticity

Stroke mortality has declined steadily in recent years. As a result, an increasing number of individuals survive but are left with various residual physical and cognitive deficits. Of these deficits, post-stroke limb spasticity (PSLS) generally occurs with motor impairment as a frequent sequela after stroke. The prevalence of PSLS, estimated from several studies with different sample sizes at varying post-stroke phases, ranges from 4% to 43%. PSLS is considered a major complication with a profound negative impact on post-stroke motor recovery and quality of life. Spasticity frequently develops weeks or months after the stroke onset. It is a significant barrier for stroke survivors from achieving good recovery or functional independence in activities of daily living (ADLs). Over the last decade, botulinum toxin has been emerging as the first-line therapy for treating PSLS. We aim to summarize the pathophysiology, anatomical correlation, and the evidence of using botulinum toxin as a safe and effective treatment option.