Ultrasound-Guided Botulinum Toxin Injection with Factor VIII Administration for Post Stroke Spasticity in a Hemophilia A Patient
Brain & Neurorehabilitation
;
: e20-2018.
Article
in English
| WPRIM
| ID: wpr-716991
ABSTRACT
Chemodenervation with botulinum toxin (BTX) has been recommended for focal spasticity. BTX injection should be performed with caution in patients with bleeding disorders and/or receiving anticoagulation therapy. We present a case of BTX injection for post-stroke spasticity in a patient with hemophilia A who could not take oral spasmolytics due to chronic hepatitis C. To minimize the bleeding risk, we replaced factor VIII intravenously in accordance with the World Federation of Hemophilia guidelines for minor surgery. FVIII (3,000 IU) was administered 15 minutes before BTX injection. One day later, 2,000 IU was administered, and 2 days later, another 2,000 IU was administered. We performed the real-time Ultrasound-guided BTX injection three times, then spasticity and upper extremity function improved without adverse events. BTX injection can be considered as a treatment option for spasticity among patients with hemophilia.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Parasympatholytics
/
Minor Surgical Procedures
/
Botulinum Toxins
/
Factor VIII
/
Ultrasonography
/
Hepatitis C, Chronic
/
Stroke
/
Upper Extremity
/
Hemophilia A
/
Hemorrhage
Type of study:
Diagnostic study
/
Practice guideline
Limits:
Humans
Language:
English
Journal:
Brain & Neurorehabilitation
Year:
2018
Type:
Article
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