Patient: Three years left hemiplegia, acupuncture hyperbaric oxygen and rehabilitative exercise exercise. Hello doctor, I am a hemiplegic patient with motor disorder due to traumatic brain injury, I am 26 years old and have been injured for three years. I can walk independently to a small extent through rehabilitation exercises, but with foot inversion and upper limb flexion, I must spend a lot of time on exercise every day, otherwise my hands and feet are stiff, especially in the morning when I wake up, the stiffness of my hands and feet is obvious and the spasm is more powerful. I feel as if I have been moving my body during the day and sleeping hard at night, and then relying on active passive and active activities the next day to relieve muscle tone and suppress irregular movements, but I can’t do anything else. I would like to ask you, is it true that a traumatic brain injury patient has to rely on many passive activities all the time in order to perform some activities of daily life? I don’t have to spend all my time on exercise every day, so I can restrain my spasms by my brain, and I don’t have to spend a lot of time on exercise every morning to restrain my spasms and get out of bed, and at the same time, I can gradually return to normal life through exercise. What can I do to change this situation or what else can I do to improve it? Thank you for your guidance, expert! I now spend most of my time between waking up in the morning and going to bed at night doing exercises, starting with anti-spastic activities, and then walking in my orthotics for more than 40 minutes in the morning and 40 minutes in the afternoon. Please take the time out of your busy schedule to give me detailed guidance on my condition, thank you! Also, I had several repeat surgeries in the months after my previous cranial repair surgery due to a medical incident, so I would like to ask you if you have any good suggestions and methods to replenish the blood supply to the affected nerves and promote the recovery of the damaged nerves. Please take the time to provide specific guidance. Or do you have any suggestions on what you think should be done to improve the recovery of my damaged nerves so that I can recover as fully as possible? Please take time out of your busy schedule to give me specific guidance. At the same time, I have uploaded a CT film taken after the last surgery due to the medical accident when I had the skull repair surgery, which caused me to suffer several repeated surgical injuries after the surgery. Guangdong Provincial Hospital of Rehabilitation Guo Youhua: At present, there is no special treatment for the late stage of craniocerebral injury, drug therapy: evidence-based medical evidence of brain nerve nutrition is cytarabine, brain rehabilitation also has a certain role in its recovery, there is also the treatment of Chinese medicine. Anti-spasticity: according to your situation, spasticity is more serious, in addition to active rehabilitation and wearing braces, if necessary, oral anti-spasticity drugs, such as baclofen, Miauna, tizanidine, etc., if the effect is still poor, it is feasible to local intramuscular injection of botulinum toxin type A anti-spasticity, if necessary, surgical treatment. The key to restoring the motor function of the limbs is long-term rehabilitation. Because there is no in-person rehabilitation assessment, we cannot provide specific rehabilitation guidance for the time being. We suggest going to the rehabilitation department of a regular hospital. Patient: Hello Professor Guo, thank you for your guidance. Baclofen is not available in our pharmacy, and it seems that the dosage needs to be changed by the doctor, right? So I don’t know what to do, and it seems that all these drugs that lower muscle tone will affect muscle strength to some extent, right? Do you know where to buy Myna, etc.? How should I take it? I would like to ask for your patience and guidance. What is the cost of botulinum toxin injection? How long does it take? Do I need to be hospitalized? Please give me specific instructions. Thank you! Guo Youhua, Department of Rehabilitation, Guangdong Hospital of Traditional Chinese Medicine: 1. Baclofen: 5mg/time (half tablet) 3 times a day (5,5,5), then increase 5mg every 3 days, i.e. 10,5,5; 10,10,5; 10,10,10. until the appropriate dose (tension is reduced, but the original function is not affected. For example, if the original can walk, if the leg is weak and can’t walk due to the medicine, it means the dose is too much and should be reduced). 2, Myona: 50mg/time (one tablet), 3 times a day. 3, botulinum toxin: domestic more than 700 yuan a, imported about 2100 yuan a, each time according to the needs of the disease generally each single limb need to inject about 4. Each time can be managed for 3 months. General hospitalization is best. —- injections and medications are intended to reduce tension after giving the opportunity for rehabilitation training. —- These oral medications have more side effects, especially baclofen, but are generally tolerated after a period of time. Botulinum toxin has almost no side effects. Patient: Hi Professor Guo, thank you for your detailed guidance on my renewed consultation. I used to think that my muscle tone would decrease after using muscle tone lowering drugs and would not rebound, so my future rehabilitation exercises would focus on functional recovery and I would not have to spend a lot of time on anti-spasticity and muscle tone lowering every day. However, I heard you say that the botulinum toxin injection only lasts for about three months and after that, it will be the same again? Do I have to keep taking the muscle tone medication to maintain it? If so, I may not want to take this medicine. I would like to ask you again, is it possible for me to perform some activities of daily living with active and active exercise and functional training, basically by suppressing the tone and spasm by the nerve center? Thank you for your guidance again. Guo Youhua, Department of Rehabilitation, Guangdong Provincial Hospital of Traditional Chinese Medicine: It is possible to rely on functional training without medication, but you may have to rely on orthopedic devices, especially during night rest, which is more arduous than medication, and you have to be persistent, progressive and never give up.