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.

Basic and Clinical Neurosciences Research Laboratory University Medical School of Marrakech Marrakech Morocco

Centre de Rééducation et Medicine Physique Hôpital du Jura Porrentruy Switzerland

Chulalongkorn Centre for Excellence on Parkinson's Disease and Related Disorders King Chulalongkorn Memorial Hospital Bangkok Thailand

Clinic 'Cecil Plus' Moscow Russia

Department of Adult Neuro Rehabilitation Adult Botulinum Toxin Clinics Centro de Medicina de Reabilitação de Alcoitão Alcabideche Portugal

Department of Neurology and Psychiatry University of Santo Tomas Hospital Manila Philippines

Department of Neurology Bonn University Bonn Germany

Department of Neurology Dr Becker Rhein Sieg Klinik Nümbrecht Germany

Department of Neurology Hospital de Clínicas José de San Martín University of Buenos Aires Buenos Aires Argentina

Department of Neurology King Faisal Specialist Hospital Riyadh Kingdom of Saudi Arabia

Department of Neurology Ljubljana University Medical Centre Ljubljana Slovenia

Department of Neurology Maternus Klinik für Rehabilitation Bad Oeynhausen Germany

Department of Neurology Movement Disorders Clinic Rasoul e Akram Hospital Iran University of Medical Sciences Tehran Iran

Department of Neurology Palacky University Olomouc Czech Republic

Department of Neurology Rostock University Rostock Germany

Department of Neurology Universidad de Monterrey Monterrey Mexico

Department of Neurology University of Tokushima Tokushima Japan

Department of Neurology University of Zagreb Zagreb Croatia

IAB Interdisciplinary Working Group for Movement Disorders Hamburg Germany

Movement Disorders Section Department of Neurology Hannover Medical School Carl Neuberg Str 1 30625 Hannover Germany

Scientific Research Institute of Neurology Moscow Russia

University of Sao Paulo Sao Paulo Brazil

Zobrazit více v PubMed

Clin Rehabil. 2013 Sep;27(9):803-12 PubMed

Curr Opin Microbiol. 2012 Jun;15(3):325-36 PubMed

Ann Readapt Med Phys. 2003 Jul;46(6):299-302 PubMed

Drugs. 2011 May 28;71(8):1043-58 PubMed

Neurochirurgie. 2003 May;49(2-3 Pt 2):265-70 PubMed

Nervenarzt. 2000 Apr;71(4):288-94 PubMed

Acta Neurol Scand. 2010 Oct;122(4):295-302 PubMed

Rev Neurol (Paris). 2001 Sep;157(8-9 Pt 2):1041-4 PubMed

Eur J Neurol. 2010 Jul;17 Suppl 1:71-80 PubMed

Cochrane Database Syst Rev. 2000;(4):CD001332 PubMed

Phys Med Rehabil Clin N Am. 2001 Nov;12(4):833-74, vii-viii PubMed

J Neural Transm (Vienna). 2008;115(4):607-16 PubMed

PM R. 2014 May;6(5):406-11 PubMed

Expert Rev Neurother. 2013 Dec;13(12 Suppl):55-9 PubMed

Axone. 1993 Jun;14(4):85-8 PubMed

Curr Neurol Neurosci Rep. 2014 Aug;14(8):463 PubMed

J Neurol. 2006 Feb;253 Suppl 1:I26-8 PubMed

Neurology. 2016 May 10;86(19):1818-26 PubMed

PM R. 2015 Apr;7(4):417-27 PubMed

Nervenarzt. 1993 Aug;64(8):517-23 PubMed

Suppl Clin Neurophysiol. 2004;57:159-66 PubMed

J Back Musculoskelet Rehabil. 2002 Jan 1;16(2):51-6 PubMed

Paediatr Drugs. 2012 Jun 1;14(3):165-77 PubMed

Clin J Pain. 2002 Nov-Dec;18(6 Suppl):S182-90 PubMed

Acta Neurol Scand. 2017 Mar;135(3):366-372 PubMed

Semin Neurol. 1998;18(3):389-95 PubMed

Neurol Neurochir Pol. 2003 Sep-Oct;37(5):1135-42; discussion 1143 PubMed

J Neurol Neurosurg Psychiatry. 2000 Jun;68(6):707-12 PubMed

Ortop Traumatol Rehabil. 2004 Oct 30;6(5):665-72 PubMed

Int J Neurosci. 2013 Jun;123(6):400-8 PubMed

Clin Rehabil. 2007 Apr;21(4):331-7 PubMed

Fortschr Neurol Psychiatr. 2005 May;73(5):268-85 PubMed

Neurology. 1980 Dec;30(12):1303-13 PubMed

Drug Saf. 2006;29(1):31-48 PubMed

Cochrane Database Syst Rev. 2001;(4):CD001332 PubMed

Int J Oral Maxillofac Surg. 1997 Dec;26(6):458-60 PubMed

Am J Phys Med Rehabil. 1993 Dec;72(6):364-8 PubMed

Health Technol Assess. 2003;7(40):iii, ix-x, 1-111 PubMed

Przegl Lek. 2007;64 Suppl 2:3-7 PubMed

Ther Clin Risk Manag. 2012;8:385-91 PubMed

Rev Neurol (Paris). 2012 Apr;168 Suppl 3:S62-8 PubMed

Semin Neurol. 2016 Feb;36(1):64-72 PubMed

Physiother Can. 2015 Spring;67(2):157-66 PubMed

Acta Neurol Scand Suppl. 2010;(190):62-6 PubMed

Wien Klin Wochenschr. 2001;113 Suppl 4:20-4 PubMed

Ann Neurol. 1990 Oct;28(4):512-5 PubMed

Neurorehabil Neural Repair. 2003 Mar;17(1):66-70 PubMed

Cochrane Database Syst Rev. 2003;(4):CD001332 PubMed

Tidsskr Nor Laegeforen. 1997 May 30;117(14):2022-4 PubMed

J Neural Transm (Vienna). 2013 Apr;120(4):705-10 PubMed

J Neural Transm (Vienna). 2015 Nov;122(11):1573-9 PubMed

Drugs. 2000 Mar;59(3):487-95 PubMed

J Neurol. 2006 Feb;253 Suppl 1:I16-20 PubMed

Neurology. 1995 Apr;45(4):712-7 PubMed

Phys Med Rehabil Clin N Am. 2003 Nov;14(4):821-35 PubMed

Ann Readapt Med Phys. 2007 Jan;50 Suppl 1:S4-6 PubMed

NeuroRehabilitation. 2014;34(1):185-92 PubMed

Eur J Neurol. 2002 May;9 Suppl 1:42-7; dicussion 53-61 PubMed

Muscle Nerve Suppl. 1997;6:S169-75 PubMed

Clin Neurol Neurosurg. 2010 Sep;112(7):592-6 PubMed

Crit Rev Phys Rehabil Med. 2013;25(1-2):11-22 PubMed

Ortop Traumatol Rehabil. 2007 May-Jun;9(3):277-85 PubMed

J Neural Transm (Vienna). 2014 May;121(5):521-30 PubMed

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