Upper Limb Spasticity in Adults


  • Stroke (most common cause)
  • Traumatic brain injury
  • Multiple sclerosis
  • Spinal cord problems (such as lesions)
  • Cerebral palsy in adults


  • Muscle stiffness (known as hypertonia)
  • Limited range of movement
  • Reduced ability to relax muscles
  • Muscle spasms
  • Changes in limb position
  • Pain
In clinical trials, most patients treated for upper limb spasticity
with XEOMIN were adults with post-stroke spasticity4-6

Common Occurrence after Stroke

  • Spasticity may be one of many possible consequences after a stroke1
  • There is a wide range of prevalence data in post-stroke spasticity, from as little as 19% to as much as 98% of patients7,8
  • The onset of spasticity after stroke is also highly variable. It may occur shortly after the stroke or more than 1 year later9

Clinical Presentation

Flexed elbow

Flexed wrist

Pronated forearm

Clenched fist



  1. Spasticity, what is it? American Stroke Association website. https://www.stroke.org/en/about-stroke/effects-of-stroke/physical-effects-of-stroke/physical-impact/spasticity. Accessed June 18, 2021.
  2. Differential diagnosis for spasticity. NeuroRehab Resource website. http://www.neurorehabresource.org/Files/NRR_Differential_Diagnosis.pdf. Accessed June 18, 2021.
  3. Spasticity. American Association of Neurological Surgeons website. https://www.aans.org/Patients/Neurosurgical-Conditions-and-Treatments/Spasticity. Accessed June 18, 2021.
  4. Elovic EP, Munin MC, Kaňovský P, Hanschmann A, Hiersemenzel R, Marciniak C. Randomized, placebo-controlled trial of incobotulinumtoxinA for upper-limb post-stroke spasticity. Muscle Nerve. 2016;53(3):415-421.
  5. Kaňovský P, Slawek J, Denes Z, et al. Efficacy and safety of botulinum neurotoxin NT 201 in poststroke upper limb spasticity. Clin Neuropharmacol. 2009;32(5):259-265.
  6. Barnes M, Schnitzler A, Medeiros L, Aguilar M, Lehnert-Batar A, Minnasch P. Efficacy and safety of NT 201 for upper limb spasticity of various etiologies—a randomized parallel-group study. Acta Neurol Scand. 2010;122(4):295-302.
  7. Wissel J, Schelosky LD, Scott J, Christe W, Faiss JH, Mueller J. Early development of spasticity following stroke: a prospective, observational trial. J Neurol. 2010;257(7):1067-1072.
  8. Ward AB. A literature review of the pathophysiology and onset of post-stroke spasticity. Eur J Neurol. 2012;19(1):21-27.
  9. Wissel J, Manack A, Brainin M. Toward an epidemiology of poststroke spasticity. Neurology. 2013;80(3 Suppl 2):S13-19.