In 1996–2001 in the Centre for Abnormal Movements and Parkinsonism at the First Neurological Clinic, St. Anne Faculty Hospital Brno treatment of spasticity by administration of botulotoxin A (Dysport®, Beaufor Ipsen International, France and Botox®, Allergan, Inc., USA) was started in a total of 28 adult patients (11 women, 17 men, mean age of group 53.5±13.2 years, mean age at time of manifestation of the basic disease 46.3±16.9 years, mean follow up period 2.8±1.9 years). From the total number of 28 patients 19 developed spasticity of the extremities due to cerebrovascular or spinal attacks, 7 patients suffered from spasticity with a posttraumatic etiology, one female patient from multiple sclerosis with marked spasticity of the lower extremities and one female patient suffered from dextrolateral spasticity as a consequence of tick-borne encephalitis in child age. The effect of administration was evaluated on the basis of subjective evaluation by the patients, clinical neurological examination and modified Ashworth scale 4–6 weeks after the first administration and then after every subsequent injection of botulotoxin A. Results: From the total number of 28 patients 25 evaluated the effect of botulotoxin A therapy on mitigation of the spasticity of the target muscles as positive. Three patients did not experience mitigation of spasticity. Improvement of the functional state of the affected extremities was observed in 15 patients. The mean score according to the modified Ashworth scale declined from the initial mean value of 3.3±1.2 degrees before treatment to 2.2±0.9 degrees (evaluated at the time of the maximum effect of botulotoxin A therapy). The mean number of injections per patient was 5.1±3.5, the mean single dose of Dysport® was 538±242 units, of Botox® 126±44 units, the mean period of onset of the effect was 6.5±4.8 days, the mean period of effectiveness of a single dose was 2.9±1.9 months.Undesirable effects were recorded in a total of 5 patients (transient muscular weakness).Treatment of adult patients by local injections of botulotoxin A is safe, effective, mitigates the spasticity of the muscles of the upper and lower extremities.

        Key words: spasticity, therapy, botulotoxin A, cerebrovascular and spinal vascular events, craniocerebral and spinal injury, multiple sclerosis