Botulinum toxin improves dysphagia associated with multiple sclerosis.
OBJECTIVE
To evaluate the efficacy of botulinum neurotoxin type A (BoNT/A) for severe oro-pharyngeal dysphagia associated with multiple sclerosis (MS).


METHODS
BoNT/A was injected percutaneously into the hyperactive cricopharyngeal muscle of 14 dysphagic MS patients under electromyographic control. Patients were evaluated by videofluoroscopic and electromyographic examinations and by the Penetration/Aspiration Scale (PAS), at week 1, 4, 12, 16, 18, and 24 after BoNT/A injection.


RESULTS
All patients showed a significant improvement in all the swallowing outcome measures.


CONCLUSIONS
No specific treatment for oro-pharyngeal dysphagia related to MS has been described to date. Our preliminary findings suggest a potential benefit from BoNT/A treatment in MS patients with dysphagia associated with upper esophageal sphincter hyperactivity.
Restivo
D A
DA
Department of Neurology, Nuovo Garibaldi Hospital, Catania, Italy. darestivo@libero.it
Marchese-Ragona
R
R
Patti
F
F
Solaro
C
C
Maimone
D
D
Zappalá
G
G
Pavone
A
A
D000328:Adult; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D003680:Deglutition Disorders / Q000188:drug therapy* / Q000209:etiology; D004576:Electromyography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications / Q000188:drug therapy*; D009465:Neuromuscular Agents / Q000627:therapeutic use*; D010609:Pharyngeal Muscles / Q000187:drug effects
D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A