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Botulinum Toxin Treatment in Multiple Sclerosis—a Review

  • Multiple Sclerosis and Related Disorders (P Villoslada, Section Editor)
  • Published:
Current Treatment Options in Neurology Aims and scope Submit manuscript

Abstract

Purpose of review The purpose of this review is to provide updated information on the role of botulinum neurotoxin (BoNT) therapy in multiple sclerosis (MS). This review aims to answer which symptoms of multiple sclerosis may be amenable to BoNT therapy.

Recent findings We searched the literature on the efficacy of BoNTs for treatment of MS symptoms up to April 1st 2017 via the Yale University Library’s search engine including but not limited to Pub Med and Ovis SP. The level of efficacy was defined according to the assessment’s criteria set forth by the Subcommittee on Guideline Development of the American Academy of Neurology. Significant efficacy was found for two indications based on the available blinded studies (class I and II) and has been suggested for several others through open-label clinical trials.

Summary There is level A evidence (effective- two or more class I) that injection of BoNT-A into the bladder’s detrusor muscle improves MS-related neurogenic detrusor overactivity (NDO) and MS-related overactive (OA) bladder. There is level B evidence (probably effective- two class II studies) for utility of intramuscular BoNT-A injections for spasticity of multiple sclerosis. Emerging data based on retrospective class IV studies demonstrates that intramuscular injection of BoNTs may help other symptoms of MS such as focal tonic spasms, focal myokymia, spastic dysphagia, and double vision in internuclear ophthalmoplegia. There is no data on MS-related trigeminal neuralgia and sialorrhea, two conditions which have been shown to respond to BoNT therapy in non-MS population.

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Authors and Affiliations

  1. University of California, Irvine (UCI), Irvine, CA, 92697, USA

    Yasaman Safarpour MD

  2. Toronto, Canada

    Tahereh Mousavi MD

  3. Yale University, New Haven, CT, 06520, USA

    Bahman Jabbari MD, FAAN

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  1. Yasaman Safarpour MD
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Yasaman Safarpour and Tahereh Mousavi declare that they have no conflict of interest.

Bahman Jabbari is an advisor for Ipsen Pharmaceutical and has received research grants from Ipsen Pharmaceutical and Merz.

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Safarpour, Y., Mousavi, T. & Jabbari, B. Botulinum Toxin Treatment in Multiple Sclerosis—a Review. Curr Treat Options Neurol 19, 33 (2017). https://doi.org/10.1007/s11940-017-0470-5

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