Evidence of chemodenervation treatment effectiveness for the neurological patient

The use of clinical chemodenervation, the combination of botulinum toxins and chemical neurolysis, for the treatment of spasticity has increased in recent years. The purpose of this paper is to review the literature describing neurological patients whose outcomes after chemodenervation are evaluated for utility and efficacy. In this paper, mechanisms of action, the side effects, an overview of injection techniques, the duration of benefit and its contraindications are reviewed.The selection of articles to review was based on whether chemodenervation was studied for the resolution of neurological impairments, most often spasticity. The articles reviewed ranged from single case studies to double blind placebo-controlled trials. Applications of chemodenervation are discussed for neurological populations including diagnoses of spinal cord injury, traumatic brain injury, cerebral palsy, multiple sclerosis, Parkinson disease, and stroke. A discussion of the potential for enhancing treatment effectiveness combining physical therapy treatments with chemodenervation is presented.