Journal of Multiple Sclerosis

Interest of Botulinum Toxin for Treatment of Spasticity in Multiple Sclerosis

Gallien P, Petrilli S, Autret K, Robineau S, Le Meur C, Berthier T, A Durufle, Houedakor J, Fraudet B and Nicolas B

Background: Pyramidal tract lesions are common in multiple sclerosis (MS) patients and cause symptoms of spasticity, weakness and paralysis. OnabotulinumtoxinA treatment for spasticity is well-recognised, but remains to be defined in MS.

Objective: Analysis of practices in the treatment of spasticity in MS in a rehabilitation centre: Treatment of spasticity in MS with onabotulinumtoxinA according to level of disability.

Methods: Retrospective patient data review was conducted on MS patients treated with onabotulinumtoxinA from 2007 to 2010 in our neurologic rehabilitation center, with the aim to assess the modalities of use and effectiveness of onabotulinumtoxinA injections in everyday clinical practice.

Results: 126 patients (mean age: 49.4 ± 11 years), with a mean Expanded Disability Status Scale (EDSS) score of 5.8 ± 1.7 (range: 2.5-9.5) received onabotulinumtoxinA treatment. Key treatment goals were improved walking in the less disabled patients (mean EDSS: 5 ± 1), and improved comfort and nursing care for the most disabled patients (mean EDSS: 7.7 ± 1).

Therapeutic benefit was assessed using a Visual Analogue Scale and results were 6 ± 2.5 and 6.3 ± 3, respectively, with repeat injections for 65% of patients

Conclusion: OnabotulinumtoxinA used in daily practice seems to be an effective, well-tolerated treatment in MS, with goals that vary according to the level of disability: i.e., improved walking and patient comfort. Further studies are needed to define the place and the effectiveness of onabotulinumtoxinA treatment in MS.