The place of the botulinum toxin in the management of multiple sclerosis.
Multiple sclerosis (MS) is the most common disabling chronic disease of the central nervous system among young adults. These patients suffer from variety of symptoms that have a profound affect on their working ability, activities of daily living and general quality of life. Treatment of these symptoms is important in order to relief them and improve daily function and quality of life. Many of these symptoms are often resistant to treatment. Botulinum toxin A (BTX) is mainly used for spasticity and bladder dysfunction in MS. It is an effective treatment option for spasticity of the thigh adductor, pes equinus, striatal toe or adductor of the shoulder joint. BTX injections are effective in reducing incontinence episodes and urinary urgency, daytime frequency and nocturia, as well as sustained improvements in quality of life of MS patients with detrusor overreactivity. In addition, BTX is potentially effective in treating pain, trigeminal neuralgia, tremor, neuro-ophthalmologic complications, facial myokymia, gastroparesis, sialorrhea, and hyperhidrosis, however no studies have confirmed its efficacy in MS patients.
Habek
Mario
M
University of Zagreb, School of Medicine, Department of Neurology, Zagreb, Croatia. mhabek@mef.hr
Karni
Arnon
A
Balash
Yakov
Y
Gurevich
Tanya
T
D001905:Botulinum Toxins / Q000009:adverse effects / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D006801:Humans; D009103:Multiple Sclerosis / Q000188:drug therapy*; D009128:Muscle Spasticity / Q000188:drug therapy / Q000209:etiology; D009465:Neuromuscular Agents / Q000009:adverse effects / Q000627:therapeutic use*; D010146:Pain / Q000209:etiology; D011788:Quality of Life; D001750:Urinary Bladder, Neurogenic / Q000188:drug therapy / Q000209:etiology
D009465:Neuromuscular Agents; D001905:Botulinum Toxins