title: Botulinum toxin therapy for treatment of spasticity in multiple sclerosis: review and recommendations of the IAB-Interdisciplinary Working Group for Movement Disorders task force.
abstract: Botulinum toxin (BT) therapy is an established treatment of spasticity due to stroke. For multiple sclerosis (MS) spasticity this is not the case. IAB-Interdisciplinary Working Group for Movement Disorders formed a task force to explore the use of BT therapy for treatment of MS spasticity. A formalised PubMed literature search produced 55 publications (3 randomised controlled trials, 3 interventional studies, 11 observational studies, 2 case studies, 35 reviews, 1 guideline) all unanimously favouring the use of BT therapy for MS spasticity. There is no reason to believe that BT should be less effective and safe in MS spasticity than it is in stroke spasticity. Recommendations include an update of the current prevalence of MS spasticity and its clinical features according to classifications used in movement disorders. Immunological data on MS patients already treated should be analysed with respect to frequencies of MS relapses and BT antibody formation. Registration authorities should expand registration of BT therapy for spasticity regardless of its aetiology. MS specialists should consider BT therapy for symptomatic treatment of spasticity.
authors: Movement Disorders Section, Department of Neurology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany. dressler.dirk@mh-hannover.de.
authors: Dirk
authors: D
authors: Dressler
authors: Chulalongkorn Centre for Excellence on Parkinson's Disease and Related Disorders, King Chulalongkorn Memorial Hospital, Bangkok, Thailand.
authors: Roongroj
authors: R
authors: Bhidayasiri
authors: Department of Neurology, King Faisal Specialist Hospital, Riyadh, Kingdom of Saudi Arabia.
authors: Saeed
authors: S
authors: Bohlega
authors: Basic and Clinical Neurosciences Research Laboratory, University Medical School of Marrakech, Marrakech, Morocco.
authors: Abderrahmane
authors: A
authors: Chahidi
authors: University of Sao Paulo, Sao Paulo, Brazil.
authors: Tae Mo
authors: TM
authors: Chung
authors: Department of Neurology, Dr. Becker Rhein-Sieg-Klinik, Nümbrecht, Germany.
authors: Markus
authors: M
authors: Ebke
authors: Department of Adult Neuro-Rehabilitation, Adult Botulinum Toxin Clinics, Centro de Medicina de Reabilitação de Alcoitão, Alcabideche, Portugal.
authors: L Jorge
authors: LJ
authors: Jacinto
authors: Department of Neurology, University of Tokushima, Tokushima, Japan.
authors: Ryuji
authors: R
authors: Kaji
authors: Centre de Rééducation et Medicine Physique, Hôpital du Jura, Porrentruy, Switzerland.
authors: Serdar
authors: S
authors: Koçer
authors: Department of Neurology, Palacky University, Olomouc, Czech Republic.
authors: Petr
authors: P
authors: Kanovsky
authors: Department of Neurology, Hospital de Clínicas José de San Martín, University of Buenos Aires, Buenos Aires, Argentina.
authors: Federico
authors: F
authors: Micheli
authors: Clinic 'Cecil Plus', Moscow, Russia.
authors: Olga
authors: O
authors: Orlova
authors: Department of Neurology, Bonn University, Bonn, Germany.
authors: Sebastian
authors: S
authors: Paus
authors: Department of Neurology, Ljubljana University Medical Centre, Ljubljana, Slovenia.
authors: Zvezdan
authors: Z
authors: Pirtosek
authors: Department of Neurology, University of Zagreb, Zagreb, Croatia.
authors: Maja
authors: M
authors: Relja
authors: Department of Neurology and Psychiatry, University of Santo Tomas Hospital, Manila, Philippines.
authors: Raymond L
authors: RL
authors: Rosales
authors: Department of Neurology, Universidad de Monterrey, Monterrey, Mexico.
authors: José Alberto
authors: JA
authors: Sagástegui-Rodríguez
authors: Department of Neurology, Maternus-Klinik für Rehabilitation, Bad Oeynhausen, Germany.
authors: Paul W
authors: PW
authors: Schoenle
authors: Department of Neurology, Movement Disorders Clinic, Rasoul-e Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.
authors: Gholam Ali
authors: GA
authors: Shahidi
authors: Scientific Research Institute of Neurology, Moscow, Russia.
authors: Sofia
authors: S
authors: Timerbaeva
authors: Department of Neurology, Rostock University, Rostock, Germany.
authors: Uwe
authors: U
authors: Walter
authors: IAB-Interdisciplinary Working Group for Movement Disorders, Hamburg, Germany.
authors: Fereshte Adib
authors: FA
authors: Saberi
mesh_terms: D065087:Acetylcholine Release Inhibitors / Q000627:therapeutic use*; D001905:Botulinum Toxins / Q000627:therapeutic use*; D006801:Humans; D009103:Multiple Sclerosis / Q000145:classification / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology; D009128:Muscle Spasticity / Q000145:classification / Q000188:drug therapy* / Q000209:etiology* / Q000503:physiopathology
chemical_list: D065087:Acetylcholine Release Inhibitors; D001905:Botulinum Toxins
keywords: Botulinum toxin; IAB-Interdisciplinary Working Group for Movement Disorders; Multiple sclerosis; Recommendations; Review; Spasticity; Therapeutic use