My Backyard

Neurologist Mason Gasper, DO, checks the effect of Botox on patient Paul Reall, while his wife Judy looks on.

Most people know of the cosmetic effect that botulinum toxin (brand name Botox) has on facial muscles, reducing the appearance of wrinkles such as “crow’s feet” that come with age. But for patients recovering from a stroke, it can do far more – reduce pain and improve quality of life.

            “It’s made a big difference for me,” said Johnston resident Paul Reall. Five and a half years ago, he was celebrating his 60^th birthday with family and friends when he began to feel sick. His family thought he was coming down with the flu. Paul took a shower and felt like the whole room was spinning. Paul was rushed to the hospital and diagnosed with a severe stroke that affected his left side.

            Therapy helped to restore some use of his left arm and leg. Paul can dress and bathe by himself. He can walk with the aid of a cane and a brace on his left leg. But walking was painful, as his big toe stood straight up due to the late effect of stroke called spasticity. Walking became difficult, as it was hard for him to wear shoes. Paul’s foot also turned inward, making balance and mobility increasingly problematical.

            His therapist in Johnston referred him to Memorial Hospital’s Spasticity and Tone Management Program. Directed by neurologist Mason Gasper, D.O., Assistant Professor of Clinical Neurosciences at The Warren Alpert Medical School of Brown University, the program is one of only a few in the state to offer botulinum toxin type A, or Botox, to treat spasticity. Botox relaxes muscles by inactivating the nerves that control them.

            Using an electromylogram to isolate the hyperactive muscle, neurologists can pinpoint the area where the injection needed. “I could feel the difference in just a few days,” states Paul.

            Neurologists, physical and occupational therapists, neurosurgeons, orthopaedic surgeons, anesthesiologists and othotics specialists work as a team to evaluate muscle tone abnormalities and to determine a course of treatment.

            Limb stiffness and pain are common symptoms of spasticity following a stroke. Spasticity is a disabling condition that leaves the muscles and tendons permanently shortened and restricts movement. According to the National Stroke Association, about 58 percent of stroke survivors experience post-stroke spasticity, and only 51 percent of those are receiving treatment for that condition.

            “Spasticity management can help reduce pain, decrease the frequency of muscle spasm, improve gait, hygiene and ability to perform activities of daily living,” notes Dr. Gasper. It can be helpful not only for stroke patients, but also for people with multiple sclerosis, cerebral palsy, amyotropic lateral sclerosis (ALS), and tremors.

            “Why suffer when you don’t have to?” asks Paul.

            To learn more about Memorial’s Spasticity and Tone Management Program, call  (401) 729-2483.