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Botulinum Toxin Injection in the Contralateral Gastrocnemius Muscle After Tibial Nerve Repair in Rats: Improvement of Functional Recovery
Washington Lima, MD; Jose Carlos Marques de Faria, MD, PhD; Alessandra Grassi Salles, MD, PhD; Rolf Gemperli, MD, PhD; Andre Coelho Nepomuceno, MD; Raquel Salomone, MD, PhD; Patricia Krunn, MD
University of Sao Paulo, Sao Paulo, Brazil
Introduction: there is evidence that transient paralysis of the contralateral nonlesioned hemiface with botulinum toxin has positive effects on the functional recovery of the paralyzed side1,2. In an attempt to reproduce this phenomenon, we created an experimental model to study the effects of botulinum toxin injection in the contralateral gastrocnemius muscle on tibial nerve regeneration in rats.
Materials & Methods: 50 rats were divided into 5 groups of 10, according to the procedure performed: I, control, II: tibial nerve sectioned and not repaired, III: tibial nerve sectioned followed by immediate neurorrhaphy, IV: tibial nerve sectioned, immediate neurorrhaphy performed and botulinum toxin injected in the contralateral gastrocnemius muscle, and V: botulinum toxin injected in the gastrocnemius muscle without surgery. The assessment methods used were: walking track, electromyography, gastrocnemius muscle weight ratio and histological analysis of the nerve.
Results: the paralysis in the group submitted to botulinum toxin injection in the gastrocnemius muscle without surgery (V) was transient and the function results returned to normal values after 8 weeks. In the 12th week of assessment, the group submitted to neurorrhaphy and botulinum toxin injection (IV) showed higher functional outcomes in walking track than the group submitted only to neurorrhaphy (III) (p = 0.001).
Conclusions: transient paralysis of the contralateral gastrocnemius muscle by botulinum toxin had positive effects on the functional recovery of rats submitted to section and repair of the tibial nerve.
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