Treatment of spasticity with botulinum toxin: a double-blind study.
We studied the effect of botulinum-A toxin on spasticity of the leg adductors in 9 patients who were either chair-bound or bed-bound with chronic stable multiple sclerosis. We injected botulinum toxin (400 mouse units) or placebo into the adductor muscles in a randomized, crossover, double-blind design. Two physicians, who were unaware of the treatment order, used an objective rating scale and independently assessed the patients; interobserver correlation was excellent (r = 0.93-0.81). We found that botulinum toxin produced a significant reduction in spasticity (p = 0.009) and a significant improvement in the ease of nursing care (p = 0.009). There were no adverse effects during this short-term trial. This is the first demonstration of the beneficial effect of botulinum toxin on focal spastic muscle contractions.
Snow
B J
BJ
Belzberg Laboratory of Clinical Neuroscience, University of British Columbia, Vancouver, Canada.
Tsui
J K
JK
Bhatt
M H
MH
Varelas
M
M
Hashimoto
S A
SA
Calne
D B
DB
D000328:Adult; D000368:Aged; D001905:Botulinum Toxins / Q000627:therapeutic use*; D004311:Double-Blind Method; D004341:Drug Evaluation; D005260:Female; D006801:Humans; D006920:Hygiene; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications / Q000451:nursing; D009128:Muscle Spasticity / Q000188:drug therapy* / Q000209:etiology; D010865:Pilot Projects; D011897:Random Allocation; D012720:Severity of Illness Index
D001905:Botulinum Toxins