TY - JOUR T1 - Botulinum toxin should be first-line treatment for poststroke spasticity JF - Journal of Neurology, Neurosurgery & Psychiatry JO - J Neurol Neurosurg Psychiatry SP - 359 LP - 359 DO - 10.1136/jnnp.2008.164889 VL - 80 IS - 4 AU - Geoffrey Sheean Y1 - 2009/04/01 UR - http://jnnp.bmj.com/content/80/4/359.abstract N2 - Each year, about 100 000 people in the UK suffer their first stroke,1 of which some will die, and many of the survivors will suffer significant impairment.2 Much of the impairment is due to neurological deficits from damage to motor, sensory and language pathways. Some survivors also develop some type of motor overactivity as a result of damage to the upper motor neurons: spasticity is one type and affects up to 38% of patients after stroke.3 Spasticity can result in postural deformity, pain and impaired passive and active movement, and consequently impaired function. Quality of life is reduced,4 and care giver burden is increased.5Before the advent of botulinum neurotoxin (BoNT) therapy, treatment of spasticity after stroke consisted of physiotherapy measures (stretching, splinting, casting) and oral anti-spasticity agents, such as baclofen, … ER -