Combined effects of botulinum toxin type A and repetitive transcranial magnetic stimulation with intensive motor training immediately after injection in a patient with chronic stroke: A case report

2019 ◽  
Vol 32 (4) ◽  
pp. 519-524 ◽  
Author(s):  
Yuichi Hirakawa ◽  
Soichiro Koyama ◽  
Shigeo Tanabe ◽  
Kazuya Takeda ◽  
Tetsuya Ueda ◽  
...  
Keyword(s):  
Case Report ◽  
Botulinum Toxin ◽  
Transcranial Magnetic Stimulation ◽  
Magnetic Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Botulinum Toxin Type A ◽  
Botulinum Toxin Type ◽  
Chronic Stroke ◽  
Motor Training ◽  
Combined Effects

Repetitive Transcranial Magnetic Stimulation Improves Depersonalization: A Case Report

CNS Spectrums ◽  
2004 ◽  
Vol 9 (5) ◽  
pp. 375-376 ◽  
Author(s):  
Alejandro M. Jiménez-Genchi
Keyword(s):  
Prefrontal Cortex ◽  
Case Report ◽  
Transcranial Magnetic Stimulation ◽  
Magnetic Stimulation ◽  
Dorsolateral Prefrontal Cortex ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Treatment Resistant ◽  
Depersonalization Disorder ◽  
Dorsolateral Prefrontal

AbstractDepersonalization disorder is a poorly understood and treatment-resistant condition. This report describes a patient with depersonalization disorder who underwent six sessions of repetitive transcranial magnetic stimulation on the left dorsolateral prefrontal cortex. Repetitive transcranial magnetic stimulation produced a 28% reduction on depersonalization scores.

scholarly journals Constraint-Induced Movement Therapy After Injection of Botulinum Toxin Type A for a Patient With Chronic Stroke: One-Year Follow-up Case Report

2015 ◽  
Vol 95 (7) ◽  
pp. 1039-1045 ◽  
Author(s):  
Satoru Amano ◽  
Takashi Takebayashi ◽  
Keisuke Hanada ◽  
Atsushi Umeji ◽  
Kohei Marumoto ◽  
...  
Keyword(s):  
Case Report ◽  
Botulinum Toxin ◽  
Muscle Tone ◽  
Botulinum Toxin Type A ◽  
Type A ◽  
Movement Therapy ◽  
Chronic Stroke ◽  
Constraint Induced Movement Therapy ◽  
Arm Function

Background and Purpose Spasticity, an aspect of upper motor neuron syndrome, is a widespread problem in patients with stroke. To date, no study has reported the long-term (up to 1 year) outcomes of botulinum toxin (BTX) injection in combination with constraint-induced movement therapy in patients with chronic stroke. In this case report, the long-term (1 year) effects of the combination of BTX type A injection and constraint-induced movement therapy on spasticity and arm function in a patient with chronic stroke and arm paresis are described. Case Description The patient was a 66-year-old man who had had an infarction in the right posterior limb of the internal capsule 4 years before the intervention. At screening, the patient was not able to voluntarily extend his interphalangeal or metacarpophalangeal joints beyond the 10 degrees required for constraint-induced movement therapy. From 12 days after BTX type A injection, the patient received 5 hours of constraint-induced movement therapy for 10 weekdays. Outcomes All outcome measures (Modified Ashworth Scale, Fugl-Meyer Assessment, Action Research Arm Test, and amount of use scale of the Motor Activity Log) improved substantially over the 1-year period (before intervention to 1 year after intervention). Repeat BTX type A injections were not necessary because muscle tone and arm function did not worsen during the observation period. Discussion The improved arm function may have reflected improvements in volitional movements and coordination or speed of movements in the paretic arm as a result of a reduction in spasticity, a reduction of learned nonuse behaviors, or use-dependent plasticity after the combination of BTX type A injection and constraint-induced movement therapy. In addition, the possibility of an influence of the passage of time or the Hawthorne effect cannot be ruled out. If this approach proves useful in future controlled studies, it may reduce the rising medical costs of the treatment of stroke.

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