[Multiple sclerosis and botulinum toxin]

Abstract

Introduction: The aim of this work was to collect litterature datas to have an indication of botulinum toxin in multiple sclerosis disease.

Method: The international literature relating the years 1982-2002 was carried out with the Medline data bank. The article presenting of the controlled studies were mainly retained.

Results: Thirty-seven articles were indexed, 6 were retained according to our criteria. The selected articles show mainly a use of botulinum toxin in the spasticity. The principal criteria of evaluation were the muscular tone, the spasms, the pain, the or passive amplitude of joint. Two articles report the effectiveness of toxin injection in acquired nystagmus and the paralysis of a vocal fold.

Discussion: This review shows that the principal indication of toxin in multiple sclerosis is spasticity with a good effectiveness of the treatment. However controlled-placebo studies among these patients are still very few. The side effects are rare but sometimes appearance of muscular weakness always making discuss the existence of a push. It is necessary to take account of these effects and their consequences before proposing the treatment.

Conclusion: Botulinum toxin has an indication in the treatment of spasticity of patients with multiple sclerosis. However more studies are necessary with more sits of injection to fix the good indications.