title: Effects of intrathecal triamincinolone-acetonide treatment in MS patients with therapy-resistant spasticity.
abstract: OBJECTIVE
  Multiple sclerosis (MS) is an autoimmune disease affecting young people and is a major cause of disability. In the course of time, disability progresses and symptoms like spasticity may occur. Spasticity is a major cost factor in MS patients. Various agents are approved for the treatment of spasticity, but each of those agents may have several side effects. Intrathecally administered steroids (triamcinolone-acetonide (TCA)) may be efficient in treating spasticity in patients with lesions in the spinal cord and no response to first-line therapeutics. The aim of this study is to show effects of TCA treatment on clinical parameters in patients with MS.
  
  
  METHODS
  This multicentre open label study included 54 patients with MS. The clinical outcome parameters were spasticity, disability, maximum walking distance, bladder function and quality of life. All patients received physiotherapy in addition to TCA treatment to obtain optimal effects on clinical parameters.
  
  
  RESULTS
  Spasticity, maximum walking distance as well as disability improved significantly (P ⩽ 0.001) during TCA applications. Bladder function improved in every seventh patient.
  
  
  CONCLUSIONS
  We observed the effects of intrathecally administered TCA on different clinical parameters including bladder function. TCA administration is a safe method to treat different symptoms in MS patients. Longitudinal trials with repeated TCA cycles are needed to show long-term effects. Besides TCA treatment, physiotherapy contributes to the improvement of clinical parameters.
authors.affiliation: 1] Department of Neurology, University of Rostock, Rostock, Germany [2] Department of Pathology, MVZ Hochstraße, Brandenburg an der Havel, Germany.
authors.forename: F
authors.initials: F
authors.lastname: Kamin
authors.affiliation: 1] Department of Neurology, University of Rostock, Rostock, Germany [2] Department of Neurology, Medical University of Vienna, Vienna, Austria.
authors.forename: P S
authors.initials: PS
authors.lastname: Rommer
authors.affiliation: 1] Department of Neurology, University of Rostock, Rostock, Germany [2] Department of Neurology, Klinikum Braunschweig, Braunschweig, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Abu-Mugheisib
authors.affiliation: Saechsisches Krankenhaus Hubertusburg, Wermsdorf, Germany.
authors.forename: W
authors.initials: W
authors.lastname: Koehler
authors.affiliation: Staedtisches Krankenhaus Martha-Maria Halle-Doelau, Halle, Germany.
authors.forename: F
authors.initials: F
authors.lastname: Hoffmann
authors.affiliation: Department of Neurology, University of Rostock, Rostock, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Winkelmann
authors.affiliation: Department of Neurology, University of Rostock, Rostock, Germany.
authors.forename: R
authors.initials: R
authors.lastname: Benecke
authors.affiliation: Department of Neurology, University of Rostock, Rostock, Germany.
authors.forename: U K
authors.initials: UK
authors.lastname: Zettl
mesh_terms: D003131:Combined Modality Therapy; D004185:Disability Evaluation; D005260:Female; D005938:Glucocorticoids / Q000009:adverse effects*; D006801:Humans; D007278:Injections, Spinal; D008297:Male; D008875:Middle Aged; D020528:Multiple Sclerosis, Chronic Progressive / Q000188:drug therapy* / Q000503:physiopathology / Q000534:rehabilitation; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000188:drug therapy* / Q000503:physiopathology / Q000534:rehabilitation; D009128:Muscle Spasticity / Q000188:drug therapy* / Q000503:physiopathology / Q000534:rehabilitation; D011788:Quality of Life; D016896:Treatment Outcome; D014222:Triamcinolone Acetonide / Q000008:administration & dosage* / Q000009:adverse effects; D016138:Walking
chemical_list: D005938:Glucocorticoids; D014222:Triamcinolone Acetonide