Objective: Present a series of cases of patients with refractory fever associated to spasticity secondary to a brain or spinal cord injury who developed refractory fever without an infectious etiology or central origin. Treatment with botulinum toxin achieved an improvement of spasticity and resolution of the fever in our patients and no recurrence of fever. This is significant because to our knowledge this has not been reported before.

Background: Brain and spinal cord injuries may cause very severe spasticity that can be associated with persistent fever. In these cases, infectious and other non-infectious causes must be ruled out.

Method: We report 14 cases treated between July 10, 2010, and December 16, 2016, who had brain injury or spinal cord injury with severe spasticity and refractory fever. Infectious and non-infectious causes of fever were studied with cultures and laboratory and imaging studies.

Results: During the treatment of 14 patients with spasticity, other causes of fever were excluded. Treatment with botulinum toxin type A improved their spasticity, and the fever resolved within a period no greater than 48 hours.

Conclusion: We report a series of cases of patients with refractory fever associated to spasticity secondary to a brain or spinal cord injury. Treatment with botulinum toxin achieved an improvement of spasticity and fast resolution of the fever in our patients. This is significant because to our knowledge this has not been reported before.

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