Botox vs. Baclofen for Upper Limb Spasticity

Inclusion Criteria: * Outpatient, male or female subjects of any race, and at least 18 years of age. Female subjects of childbearing potential must have a negative urine pregnancy test result at Baseline (test must have a sensitivity of at least 50mlU/ml for human chorionic gonadotropin) and practice a reliable method of contraception throughout the study; * Minimal 4-month history stable neurological disorder resulting focal upper limb muscle spasticity (wrist and/or elbow) * Disability Assessment Scale (DAS) ≥ 2 for the principal therapeutic intervention target as chosen by Investigator and Subject (i.e., hygiene, dressing, pain and cosmesis). * Subjects who are able to understand the requirements of the study and sign Informed Consent/HIPAA Authorization forms. Exclusion Criteria: * Female subjects who are pregnant (positive urine pregnancy test) or who have an infant they are breast-feeding or who are of childbearing potential and are not practicing a reliable method of birth control. * Severe contracture at the wrist or a history of tendon transfer in the study limb. * Cast of study limb within four weeks of Visit 1. * Profound atrophy of the muscles in the target area(s) of injection. * Progressive neurological disorder (e.g., multiple sclerosis). * Myasthenia Gravis, Eaton-Lambert Syndrome, Amyotrophic Lateral Sclerosis or any other disease that might interfere with neuromuscular function. * Orthostatic hypotension or current use of alpha-2 adrenergic agonists (e.g. clonidine). * Current anticoagulant therapy and INR \> 3.5 * Significantly impaired renal and/or hepatic function, in the opinion of the Investigator. * Failure to meet prohibited concomitant medication criteria (Supplement I) * Subjects planning inpatient surgery during the study. * Any uncontrolled systemic disease. * Allergy or sensitivity to any component of the study medication. * Recent alcohol or drug abuse. * History of poor cooperation, non-compliance with medical treatment, or unreliability. * Subjects currently participating in an investigational drug study or who have participated in an investigational drug study within 30 days of the Baseline Visit.