Treatment with Botulinum Toxin for Refractory Fever Caused by Severe Spasticity: A Case Series.

[INTRODUCTION] Brain and spinal cord injuries may cause very severe spasticity that occasionally may be associated with persistent fever.

[CASE SERIES] We present 14 patients with spasticity and persistent fever, treated with botulinum toxin type A. Their spasticity improved and the fever resolved within a period no greater than 48 h. In all cases, infectious and other non-infectious causes were ruled out.

[CONCLUSIONS] When sustained tonic muscular activity is associated with a significant increase in body temperature and is refractory to the usual drugs used for hyperpyrexia, type A botulinum toxin may be an effective treatment option to control both spasticity and fever.