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Spastic tone can increase the difficulty of appropriately positioning the patient for botulinum toxin injections, lengthen procedure duration, and increase periprocedural pain. Our patient, a 53\u2010year\u2010old woman, was unable to be adequately positioned to receive botulinum toxin injections to her left upper extremity because of challenging flexion synergy posturing and related positional pain. A left interscalene brachial plexus local anesthetic block administered under ultrasound guidance was used to produce both temporary dense muscle relaxation and profound anesthesia, facilitating successful and comfortable botulinum toxin injections in this patient.<\/jats:p><\/jats:sec>","DOI":"10.1016\/j.pmrj.2015.07.010","type":"journal-article","created":{"date-parts":[[2015,8,7]],"date-time":"2015-08-07T04:04:55Z","timestamp":1438920295000},"page":"180-182","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Novel Use of Regional Anesthesia for Spastic Hemiplegia Evaluation and Treatment: A Case Report"],"prefix":"10.1002","volume":"8","author":[{"given":"Ameet S.","family":"Nagpal","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maxim S.","family":"Eckmann","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jon","family":"Benfield","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,8,4]]},"reference":[{"key":"e_1_2_5_2_2","first-page":"811","volume-title":"Physical Medicine & Rehabilitation Board Review","author":"Elovic E.","year":"2010"},{"key":"e_1_2_5_3_2","doi-asserted-by":"publisher","DOI":"10.1615\/CritRevPhysRehabilMed.2013007945"},{"key":"e_1_2_5_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmrj.2014.09.021"},{"key":"e_1_2_5_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/hs0901.095682"},{"key":"e_1_2_5_6_2","doi-asserted-by":"crossref","first-page":"215","DOI":"10.3233\/NRE-2012-0791","article-title":"Intra\u2010rater reliability of the Modified Ashworth Scale (MMAS) in the assessment of upper\u2010limb muscle spasticity","volume":"31","author":"Ansari N.N.","year":"2012","journal-title":"NeuroRehabilitation"},{"key":"e_1_2_5_7_2","doi-asserted-by":"publisher","DOI":"10.1053\/apmr.2002.35474"},{"key":"e_1_2_5_8_2","doi-asserted-by":"crossref","first-page":"746","DOI":"10.2340\/16501977-1851","article-title":"Reliability of a new scale for measurement of spasticity in stroke patients","volume":"46","author":"Li F.","year":"2014","journal-title":"J Rehabil Med"},{"key":"e_1_2_5_9_2","first-page":"415","article-title":"Brachial plexus anesthesia: An analysis of options","volume":"66","author":"Brown D.L.","year":"1993","journal-title":"Yale J Biol Med"},{"key":"e_1_2_5_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12630-012-9874-6"},{"key":"e_1_2_5_11_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2044.2012.07222.x"}],"container-title":["PM&amp;R"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1934148215009193?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1934148215009193?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1016\/j.pmrj.2015.07.010","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1016\/j.pmrj.2015.07.010","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1016\/j.pmrj.2015.07.010","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,14]],"date-time":"2023-09-14T18:38:06Z","timestamp":1694716686000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1016\/j.pmrj.2015.07.010"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,8,4]]},"references-count":10,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2016,2]]}},"alternative-id":["10.1016\/j.pmrj.2015.07.010"],"URL":"https:\/\/doi.org\/10.1016\/j.pmrj.2015.07.010","archive":["Portico"],"relation":{},"ISSN":["1934-1482","1934-1563"],"issn-type":[{"value":"1934-1482","type":"print"},{"value":"1934-1563","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,8,4]]},"assertion":[{"value":"2015-05-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2015-07-25","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2015-08-04","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}