United Brachial Plexus Network, Inc.

Our daughter, Aria, had her 6 month post-primary checkup yesterday with Dr. Kozin. She has extremely weak biceps movement, and he feels her triceps is so strong that it is "always on" and not giving her biceps a chance to strengthen through use.

If Aria cannot use her biceps to bend her elbow to 90 degrees by October, Dr. Kozin wants to botox her triceps to give her biceps a chance to work unopposed.

Has anyone here tried this?

Hi Mica,
We have done this exact same thing. Lucy had a very severe injury to her left arm. Her Dr. (Dr.Schwentker)said that she only had 2 viable nerve roots to graft to when she was doing the reconstruction (C5 - T1 were involved). We did her surgery at 3 months of age. She is now 2. We did botox in her tricep this past March for the same reason Dr. Kozin has given you. Her Dr. felt that the way her nerves were reconnected that the bicep and tricep would fire at the same time but her tricep would always dominate b/c it was stronger. Her Dr. says that the botox is still working but Lucy still has very limited elbow flexion indicating that the bicep is really firing. She has some bicep but I guess not what we were all hoping that it would be.

I went to the appointment wondering if I would see her elbow bend immediately after he injected the botox but he told me that it would take at least 2 to 3 weeks for it to begin working. He said to expect the injection to last 3 to 6 months, possibly even 9.

We just had an appt. with Dr.Schwentker last week and she reminded us as always that the recovery from reconstruction can take up to 4 years and that Lucy had a very severe injury and the nerves had a LONG way to grow. So as always we continue to wait. . .

Hope that helps. The botox injection didn't seem to hurt Lucy, she was more upset that we had to practically sit on top of her to hold her still enough for the Dr. to inject her - she was not sedated for the procedure obviously. I have read that Dr.Kozin does his botox injections more precisely using EMG at the same time to locate the exact muscles he wants to inject.

Best of luck with the procedure, it definitely won't hurt to try it.

Carol, mom to Lucy, 2, LOBPI

Thank you, Carol. I hope Lucy continues to improve.

This injury is so insidious...

Mica, we had this exact procedure done in April on our daughter. She had the primary nerve graft at 8 months and then one year later, still only had a slight bend at her elbow. She too had the too stong tricep that was "always on" and we felt this was a nonsurgical option that we were willing to try.
We did have our daughter sedated and the doctor did an EMG to ensure proper placing of the botox. We saw results in less than a week. She was able to bend her arm up and bring her hand to her mouth within a month. We are now trying to bulk up the bicep so when the botox wears off, it will (hopefully) be as strong as the tricep.
We would and will do it again if needed. Good luck and I hope you get the results you want! Let me know if you have any more questions--

Alisa
Zadyn, LOBPI, 23 months old

Wow! That gives us hope! What amazing results!

Hope she continues to have such great progress!

Hey Mica,

Cassidy didn't have the injections in her tricep...she had them in her pec,subscapularis and her lat. They gave them to her fort he same reason though and the results were really,really good....just thought I would share....
take care,I'm glad little Aria is improving some.
Dawn

Hi Mica!
Harper had this done at the same time as primary surgery. I cannot attest to how it has helped movement since we still are in the dreadful waiting period. However, I can say that her natural arm posture was so much better after the botox and we are able to externally rotate her arm so much easier. It was so tight before it was almost impossible to turn her arm. The botox is starting to wear off so we'll see what happens now.
I'm glad Aria is doing well

~Lisa

Thanks, guys! I really appreciate the advice and well wishes for our little girl!