How is resistance to BoNT-A assessed in the treatment of spasticity?

Updated: Jun 28, 2019
  • Author: Krupa Pandey, MD; Chief Editor: Stephen A Berman, MD, PhD, MBA  more...
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Several types of assays are available to detect the presence of antibody in serum. The most widely used is the in vivo mouse neutralization assay. Injecting 10-20 U into 1 corrugator/frontalis muscle and testing for the ability to elevate 1 eyebrow and frown 2-3 weeks later is a simple clinical way to check for resistance. Checking for a marked decrease in compound motor action potential (CMAP) amplitude in an injected muscle may be helpful. This would indicate that resistance has not developed and that the dose or injection site may have been suboptimal.

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