Abstract
Painful tonic spasms (PTS) involving upper or lower limbs can occur in patients with multiple sclerosis (MS). They may be disabling and difficult to manage.1-3⇓⇓ PTS have been attributed to ephaptic spreading of abnormal transient electric discharges throughout demyelinated axons, in the spinal cord, brainstem, or hemispheric white matter.4,5⇓ PTS are usually treated with antiepileptic medications such as carbamazepine, phenytoin, gabapentin, or benzodiazepines.1-3⇓⇓ These drugs, which require daily administration, may not provide adequate relief or may cause adverse effects.1 Because botulinum neurotoxin type A (BoNT/A) has proven effective in the treatment of hypertonic muscular activity of varying etiologies,6,7⇓ we tested it on patients with MS and PTS. We treated five patients with MS (three men, two women; age range 25 to 52 years), including three with a relapsing-remitting and two with a secondary progressive form. Clinical data are reported in table 1A. View this table: Table 1A. Clinical data of the five patients with multiple sclerosis …
Published Version
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