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Botulinum Toxin for Symptomatic Therapy in Multiple Sclerosis

  • Demyelinating Disorders (DN Bourdette and V Yadav, Section Editors)
  • Published:
Current Neurology and Neuroscience Reports Aims and scope Submit manuscript

Abstract

Botulinum toxin (BT) is a neurotoxin that paralyzes muscles by inhibiting release of acetylcholine from presynaptic vesicles at the neuromuscular junction. In people with multiple sclerosis (MS), clinical experience and research studies show that local injection of minute quantities of BT can temporarily control skeletal muscle spasticity, bladder detrusor hyperreflexia, and tremor. Specifically, BT injections have been shown to reduce muscle tone and improve passive function, and possibly improve active function, in patients with spasticity. Injection of BT into the bladder wall is a uniquely effective, safe, and durable treatment in patients with neurogenic detrusor hyperreflexia due to MS who have insufficient response or who do not tolerate oral antimuscarinic medications. This procedure has markedly reduced the need for indwelling catheters and bladder surgery. In addition, a recent study suggests BT may be effective for select patients with MS-associated upper extremity tremor. Appropriate use of BT can improve quality of life for many patients with MS.

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Papers of particular interest, published recently, have been highlighted as: •• Of major importance

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Compliance with Ethics Guidelines

Conflict of Interest

Michelle H. Cameron and Meredith Frederick declare that they have no conflict of interest.

Francois Bethoux has received consultancy fees from Concert Pharmaceuticals, Merz Pharma, Medtronic, and GW Pharma, along with grants from Merz Pharma and Medtronic. He has also received payments from Allergan for development of educational presentations.

Nina Davis has received payments from Astellas Pharmaceuticals for development of educational presentations.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Authors and Affiliations

  1. Neurology Department, Oregon Health & Science University and Portland VA Medical Center, 3181 SW Sam Jackson Park Rd, L226, Portland, OR, USA

    Michelle H. Cameron & Meredith Frederick

  2. The Mellen Center for MS Treatment and Research, The Cleveland Clinic, 9500 Euclid Avenue, Desk U10, Cleveland, OH, 44195, USA

    Francois Bethoux

  3. Urology Department, Oregon Health & Science University and Portland VA Medical Center, 3181 SW Sam Jackson Park Rd, Portland, OR, USA

    Nina Davis

Authors
  1. Michelle H. Cameron
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  2. Francois Bethoux
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  3. Nina Davis
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  4. Meredith Frederick
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Correspondence to Michelle H. Cameron.

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This article is part of the Topical Collection on Demyelinating Disorders

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Cameron, M.H., Bethoux, F., Davis, N. et al. Botulinum Toxin for Symptomatic Therapy in Multiple Sclerosis. Curr Neurol Neurosci Rep 14, 463 (2014). https://doi.org/10.1007/s11910-014-0463-7

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  • DOI: https://doi.org/10.1007/s11910-014-0463-7

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