(Snow BJ,Tsui JKC, Bhart MH, Varelas M, Hashimoto SA,
Calne DB. Treatment of spasticity with botulinum toxin: a double-blind study.
Ann Neurol 1990;28:512-515.)

How many spams has the patient had in the last 24 hours in affected muscles or extremity?

Definitions of Spams:
(1) Spasm is a jumping or twitching of the muscle or limb without control;
(2) A spasm canbe a ” shooting” of the body part into position without,
(3) A rapid series of “spasms” without significan pausing/resting is defined as one spasm.

1. No spasms

2. One spasm of fewer per day

3. Between one and five spasms per day

4. Between five and nine spasms per day

5. Ten or more spasms per day