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Restoring Function After Stroke

UC San Diego Health System takes a comprehensive approach to arm, hand and leg dysfunction following stroke or brain injury. Using novel and innovative treatments, our stroke restoration specialists are able to bring back the functionality and quality of life.

Stroke Affects Function

Nearly 80 percent of people who recover from a stroke still have trouble with limb function, despite advanced rehabilitation efforts.

Difficulty controlling movement and partial paralysis (hemiplegia and hemiparesis) are some of the most common side effects of a stroke. Specifically, stroke can result in difficulty moving the arm, opening and closing the hand, and walking.

After A Stroke

After a stroke, the nervous system attempts to “rewire” and repair itself to compensate for the lost motor systems. In many cases, the nervous system is unable to restore normal control to all of the muscles.

Some muscles do not respond at all, while others are significantly overactive, resulting in dysfunctional postures of the arm and hand. These dysfunctional muscles at times hide muscles that may actually have good control.

Surgery and Treatment

Rehabilitation is usually tried for a year before surgery or other treatments are considered.

Treatment techniques our team uses to restore function:

  1. Botox injections
  2. Partial cutting of an overactive nerve (neurotomy)
  3. Transfer of nerves to restore function to inactive muscles (nerve transfer)
  4. Lengthening or cutting of tendons that become shortened and immobile
  5. Rerouting of tendons to balance forces across a joint (tendon transfer)

Personal Treatment Plan

Our specialists work with you to develop the most effective plan for restoring function.

In order to determine the best course of treatment, we:

  • Identify the level of electrical activity present in each muscle.
  • Test specific muscles within the arm using diagnostic technologies (e.g., multichannel EMG studies).

In order to predict the effectiveness of surgical treatment, local injections of Botox are given prior to surgery. These injections mimic the effect of surgery by temporarily relaxing the problematic muscle(s).

Our Team

Our multidisciplinary team includes:

  • Geoffrey Sheean, MD,  an expert in the diagnostic testing and in the application of Botox for reducing spasticity.
  • Justin Brown, MD, an expert in peripheral neurotomies to reduce spasticity within specific muscles and nerve transfers for restoring activity to inactive muscle groups.